National Provider Identifier [NPI]: |
1912011503 |
Last Name Of The Provider |
MICHAUD |
First Name Of The Provider |
FARYAL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4001 J ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958193626 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
711 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
287355 |
Total Medicare Allowed Amount |
87713.22 |
Total Medicare Payment Amount |
68703.36 |
Total Medicare Standardized Payment Amount |
68496.83 |
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 |
19 |
Number Of Medical Services |
711 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
287355 |
Total Medical Medicare Allowed Amount |
87713.22 |
Total Medical Medicare Payment Amount |
68703.36 |
Total Medical Medicare Standardized Payment Amount |
68496.83 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
34 |
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
174 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
60 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.5635 |