National Provider Identifier [NPI]: |
1063518785 |
Last Name Of The Provider |
HOEKSTRA |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
80 68TH ST SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495486980 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
647.5 |
Number Of Medicare Beneficiaries |
328 |
Total Submitted Charge Amount |
68940.5 |
Total Medicare Allowed Amount |
28549.73 |
Total Medicare Payment Amount |
20145.03 |
Total Medicare Standardized Payment Amount |
21175.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
101.5 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
380.5 |
Total Drug Medicare AllowedAmount |
190.63 |
Total Drug Medicare PaymentAmount |
179 |
Total Drug Medicare Standardized Payment Amount |
179 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
546 |
Number Of Medicare Beneficiaries With Medical Services |
328 |
Total Medical Submitted Charge Amount |
68560 |
Total Medical Medicare Allowed Amount |
28359.1 |
Total Medical Medicare Payment Amount |
19966.03 |
Total Medical Medicare Standardized Payment Amount |
20996.85 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
253 |
Number Of Black or African American Beneficiaries |
40 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0679 |