National Provider Identifier [NPI]: |
1275589863 |
Last Name Of The Provider |
TAY |
First Name Of The Provider |
EUGENE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5171 PLAINFIELD AVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495251048 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
506 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
45909 |
Total Medicare Allowed Amount |
35633.42 |
Total Medicare Payment Amount |
23829.12 |
Total Medicare Standardized Payment Amount |
24617.89 |
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 |
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Total Drug Medicare PaymentAmount |
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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 |
67 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
191 |
Number Of Black or African American Beneficiaries |
41 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5079 |