National Provider Identifier [NPI]: |
1508951971 |
Last Name Of The Provider |
GRATIOT-DEANS |
First Name Of The Provider |
JEANNE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
330 E BELTLINE AVE NE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495061267 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
2840 |
Number Of Medicare Beneficiaries |
640 |
Total Submitted Charge Amount |
511451.5 |
Total Medicare Allowed Amount |
290055.78 |
Total Medicare Payment Amount |
223163.1 |
Total Medicare Standardized Payment Amount |
230149.73 |
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 |
22 |
Number Of Medical Services |
2840 |
Number Of Medicare Beneficiaries With Medical Services |
640 |
Total Medical Submitted Charge Amount |
511451.5 |
Total Medical Medicare Allowed Amount |
290055.78 |
Total Medical Medicare Payment Amount |
223163.1 |
Total Medical Medicare Standardized Payment Amount |
230149.73 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
234 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
334 |
Number Of Non Hispanic White Beneficiaries |
459 |
Number Of Black or African American Beneficiaries |
116 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
384 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
256 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
5.2026 |