National Provider Identifier [NPI]: |
1073608568 |
Last Name Of The Provider |
RUOFF |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 SOUTH GARFIELD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TRAVERSE CITY |
Zip Code Of The Provider |
49686 |
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 |
50 |
Number Of Services |
2438.5 |
Number Of Medicare Beneficiaries |
279 |
Total Submitted Charge Amount |
176606.6 |
Total Medicare Allowed Amount |
136891.16 |
Total Medicare Payment Amount |
98097 |
Total Medicare Standardized Payment Amount |
105543.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
211.5 |
Number Of Medicare Beneficiaries With Drug Services |
188 |
Total Drug Submitted ChargeAmount |
4981.5 |
Total Drug Medicare AllowedAmount |
4046.6 |
Total Drug Medicare PaymentAmount |
3885.1 |
Total Drug Medicare Standardized Payment Amount |
3885.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
2227 |
Number Of Medicare Beneficiaries With Medical Services |
279 |
Total Medical Submitted Charge Amount |
171625.1 |
Total Medical Medicare Allowed Amount |
132844.56 |
Total Medical Medicare Payment Amount |
94211.9 |
Total Medical Medicare Standardized Payment Amount |
101657.93 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.935 |