National Provider Identifier [NPI]: |
1619968856 |
Last Name Of The Provider |
FIELD |
First Name Of The Provider |
E |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4677 TOWNE CENTRE RD |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
SAGINAW |
Zip Code Of The Provider |
486042846 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1255 |
Number Of Medicare Beneficiaries |
666 |
Total Submitted Charge Amount |
635263 |
Total Medicare Allowed Amount |
294297.29 |
Total Medicare Payment Amount |
228746.6 |
Total Medicare Standardized Payment Amount |
225481.41 |
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 |
51 |
Number Of Medical Services |
1255 |
Number Of Medicare Beneficiaries With Medical Services |
666 |
Total Medical Submitted Charge Amount |
635263 |
Total Medical Medicare Allowed Amount |
294297.29 |
Total Medical Medicare Payment Amount |
228746.6 |
Total Medical Medicare Standardized Payment Amount |
225481.41 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
187 |
Number Of Beneficiaries Age 65 to 74 |
229 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
344 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
611 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
477 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.3078 |