National Provider Identifier [NPI]: |
1861433302 |
Last Name Of The Provider |
KOMASARA |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16001 W 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480754818 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
1775 |
Number Of Medicare Beneficiaries |
1120 |
Total Submitted Charge Amount |
555946.11 |
Total Medicare Allowed Amount |
172456.45 |
Total Medicare Payment Amount |
124859.96 |
Total Medicare Standardized Payment Amount |
126846.07 |
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 |
43 |
Number Of Medical Services |
1775 |
Number Of Medicare Beneficiaries With Medical Services |
1120 |
Total Medical Submitted Charge Amount |
555946.11 |
Total Medical Medicare Allowed Amount |
172456.45 |
Total Medical Medicare Payment Amount |
124859.96 |
Total Medical Medicare Standardized Payment Amount |
126846.07 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
388 |
Number Of Beneficiaries Age 65 to 74 |
305 |
Number Of Beneficiaries Age 75 to 84 |
279 |
Number Of Beneficiaries Age Greater 84 |
148 |
Number Of Female Beneficiaries |
647 |
Number Of Male Beneficiaries |
473 |
Number Of Non Hispanic White Beneficiaries |
831 |
Number Of Black or African American Beneficiaries |
216 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
659 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
461 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0417 |