National Provider Identifier [NPI]: |
1568437762 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
CARLOS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6060 TORREY RD |
Street Address 2 Of The Provider |
STE I |
City Of The Provider |
FLINT |
Zip Code Of The Provider |
485075963 |
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 |
21 |
Number Of Services |
12468 |
Number Of Medicare Beneficiaries |
423 |
Total Submitted Charge Amount |
1050496.66 |
Total Medicare Allowed Amount |
383301.94 |
Total Medicare Payment Amount |
294886.08 |
Total Medicare Standardized Payment Amount |
299965.05 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
188 |
Number Of Non Hispanic White Beneficiaries |
365 |
Number Of Black or African American Beneficiaries |
46 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.794 |