National Provider Identifier [NPI]: |
1154619492 |
Last Name Of The Provider |
PERAM |
First Name Of The Provider |
INDEEVAR |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
G3200 BEECHER RD |
Street Address 2 Of The Provider |
SUITE 2 |
City Of The Provider |
FLINT |
Zip Code Of The Provider |
485323651 |
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 |
14 |
Number Of Services |
752 |
Number Of Medicare Beneficiaries |
352 |
Total Submitted Charge Amount |
219692 |
Total Medicare Allowed Amount |
78774.26 |
Total Medicare Payment Amount |
61761.31 |
Total Medicare Standardized Payment Amount |
65803.45 |
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 |
14 |
Number Of Medical Services |
752 |
Number Of Medicare Beneficiaries With Medical Services |
352 |
Total Medical Submitted Charge Amount |
219692 |
Total Medical Medicare Allowed Amount |
78774.26 |
Total Medical Medicare Payment Amount |
61761.31 |
Total Medical Medicare Standardized Payment Amount |
65803.45 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
283 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
41 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0852 |