National Provider Identifier [NPI]: |
1255372504 |
Last Name Of The Provider |
FOOTE |
First Name Of The Provider |
JAMES |
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 |
2060 E PARIS AVE SE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495466113 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
268544.9 |
Total Medicare Allowed Amount |
98884.94 |
Total Medicare Payment Amount |
73740.9 |
Total Medicare Standardized Payment Amount |
79844.66 |
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 |
29 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
166 |
Total Medical Submitted Charge Amount |
268544.9 |
Total Medical Medicare Allowed Amount |
98884.94 |
Total Medical Medicare Payment Amount |
73740.9 |
Total Medical Medicare Standardized Payment Amount |
79844.66 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
137 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
20 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2036 |