National Provider Identifier [NPI]: |
1255324802 |
Last Name Of The Provider |
MICHAEL |
First Name Of The Provider |
FREDERICK |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
19251 MACK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GROSSE POINTE WOODS |
Zip Code Of The Provider |
482362893 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
935 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
82755.08 |
Total Medicare Allowed Amount |
62870.77 |
Total Medicare Payment Amount |
47193.49 |
Total Medicare Standardized Payment Amount |
44695.51 |
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 |
23 |
Number Of Medical Services |
935 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
82755.08 |
Total Medical Medicare Allowed Amount |
62870.77 |
Total Medical Medicare Payment Amount |
47193.49 |
Total Medical Medicare Standardized Payment Amount |
44695.51 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
103 |
Number Of Black or African American Beneficiaries |
244 |
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 |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.843 |