National Provider Identifier [NPI]: |
1750355640 |
Last Name Of The Provider |
GREY |
First Name Of The Provider |
JULIANA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
36123 SCHOOLCRAFT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LIVONIA |
Zip Code Of The Provider |
481501216 |
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 |
12 |
Number Of Services |
1382 |
Number Of Medicare Beneficiaries |
435 |
Total Submitted Charge Amount |
274462 |
Total Medicare Allowed Amount |
138055.84 |
Total Medicare Payment Amount |
104692.77 |
Total Medicare Standardized Payment Amount |
107635.73 |
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 |
12 |
Number Of Medical Services |
1382 |
Number Of Medicare Beneficiaries With Medical Services |
435 |
Total Medical Submitted Charge Amount |
274462 |
Total Medical Medicare Allowed Amount |
138055.84 |
Total Medical Medicare Payment Amount |
104692.77 |
Total Medical Medicare Standardized Payment Amount |
107635.73 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
220 |
Number Of Female Beneficiaries |
319 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
411 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
262 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.9151 |