National Provider Identifier [NPI]: |
1639212269 |
Last Name Of The Provider |
AMPRIM |
First Name Of The Provider |
FRANK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21540 W 11 MILE RD |
Street Address 2 Of The Provider |
SUITE# 200 |
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480763843 |
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 |
25 |
Number Of Services |
2463 |
Number Of Medicare Beneficiaries |
328 |
Total Submitted Charge Amount |
254188.64 |
Total Medicare Allowed Amount |
223894.27 |
Total Medicare Payment Amount |
168883.09 |
Total Medicare Standardized Payment Amount |
164401.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
77 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
1758.46 |
Total Drug Medicare AllowedAmount |
1630.37 |
Total Drug Medicare PaymentAmount |
1594.92 |
Total Drug Medicare Standardized Payment Amount |
1594.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
2386 |
Number Of Medicare Beneficiaries With Medical Services |
328 |
Total Medical Submitted Charge Amount |
252430.18 |
Total Medical Medicare Allowed Amount |
222263.9 |
Total Medical Medicare Payment Amount |
167288.17 |
Total Medical Medicare Standardized Payment Amount |
162806.55 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
268 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
114 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
214 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.5018 |