National Provider Identifier [NPI]: |
1811152887 |
Last Name Of The Provider |
MIN |
First Name Of The Provider |
JIANGYONG |
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 |
220 CHERRY ST SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495034608 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
667 |
Number Of Medicare Beneficiaries |
338 |
Total Submitted Charge Amount |
119578 |
Total Medicare Allowed Amount |
78502.62 |
Total Medicare Payment Amount |
60309.91 |
Total Medicare Standardized Payment Amount |
62254.07 |
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 |
17 |
Number Of Medical Services |
667 |
Number Of Medicare Beneficiaries With Medical Services |
338 |
Total Medical Submitted Charge Amount |
119578 |
Total Medical Medicare Allowed Amount |
78502.62 |
Total Medical Medicare Payment Amount |
60309.91 |
Total Medical Medicare Standardized Payment Amount |
62254.07 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
274 |
Number Of Black or African American Beneficiaries |
47 |
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 |
204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
134 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
45 |
Average HCC Risk Score Of Beneficiaries |
1.9444 |