National Provider Identifier [NPI]: |
1215967872 |
Last Name Of The Provider |
SEALEY |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6001 W OUTER DR |
Street Address 2 Of The Provider |
SUITE 445 |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482352614 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
2543 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
552650 |
Total Medicare Allowed Amount |
386654.45 |
Total Medicare Payment Amount |
299353.79 |
Total Medicare Standardized Payment Amount |
296922.42 |
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 |
8 |
Number Of Medical Services |
2543 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
552650 |
Total Medical Medicare Allowed Amount |
386654.45 |
Total Medical Medicare Payment Amount |
299353.79 |
Total Medical Medicare Standardized Payment Amount |
296922.42 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
129 |
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 |
62 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
73 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.3727 |