National Provider Identifier [NPI]: |
1043267255 |
Last Name Of The Provider |
PILCHAK |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16001 W 9 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480754818 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
442 |
Number Of Medicare Beneficiaries |
302 |
Total Submitted Charge Amount |
228645 |
Total Medicare Allowed Amount |
52747.93 |
Total Medicare Payment Amount |
41059.91 |
Total Medicare Standardized Payment Amount |
39479.76 |
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 |
442 |
Number Of Medicare Beneficiaries With Medical Services |
302 |
Total Medical Submitted Charge Amount |
228645 |
Total Medical Medicare Allowed Amount |
52747.93 |
Total Medical Medicare Payment Amount |
41059.91 |
Total Medical Medicare Standardized Payment Amount |
39479.76 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
271 |
Number Of Black or African American Beneficiaries |
19 |
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 |
255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9304 |