National Provider Identifier [NPI]: |
1154594356 |
Last Name Of The Provider |
TANASE |
First Name Of The Provider |
ARMAND |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1521 GULL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490481640 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
701 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
270016 |
Total Medicare Allowed Amount |
118645.71 |
Total Medicare Payment Amount |
92136.72 |
Total Medicare Standardized Payment Amount |
94403.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
701 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
270016 |
Total Medical Medicare Allowed Amount |
118645.71 |
Total Medical Medicare Payment Amount |
92136.72 |
Total Medical Medicare Standardized Payment Amount |
94403.83 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
249 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.6182 |