National Provider Identifier [NPI]: |
1508801564 |
Last Name Of The Provider |
GRANADOS |
First Name Of The Provider |
ALISON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15474 HAGGERTY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTHVILLE |
Zip Code Of The Provider |
481704893 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
111810 |
Number Of Medicare Beneficiaries |
478 |
Total Submitted Charge Amount |
912976.11 |
Total Medicare Allowed Amount |
391177.9 |
Total Medicare Payment Amount |
304801.21 |
Total Medicare Standardized Payment Amount |
299022.96 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
108702 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
248768.11 |
Total Drug Medicare AllowedAmount |
109575.88 |
Total Drug Medicare PaymentAmount |
85882.04 |
Total Drug Medicare Standardized Payment Amount |
85882.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
3108 |
Number Of Medicare Beneficiaries With Medical Services |
478 |
Total Medical Submitted Charge Amount |
664208 |
Total Medical Medicare Allowed Amount |
281602.02 |
Total Medical Medicare Payment Amount |
218919.17 |
Total Medical Medicare Standardized Payment Amount |
213140.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
260 |
Number Of Male Beneficiaries |
218 |
Number Of Non Hispanic White Beneficiaries |
367 |
Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
373 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.2824 |