National Provider Identifier [NPI]: |
1447453840 |
Last Name Of The Provider |
VANKLOMPENBERG |
First Name Of The Provider |
LUKE |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
602 MICHIGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLLAND |
Zip Code Of The Provider |
494234918 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
737 |
Number Of Medicare Beneficiaries |
455 |
Total Submitted Charge Amount |
202526 |
Total Medicare Allowed Amount |
64902.05 |
Total Medicare Payment Amount |
46791.52 |
Total Medicare Standardized Payment Amount |
47780.87 |
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 |
28 |
Number Of Medical Services |
737 |
Number Of Medicare Beneficiaries With Medical Services |
455 |
Total Medical Submitted Charge Amount |
202526 |
Total Medical Medicare Allowed Amount |
64902.05 |
Total Medical Medicare Payment Amount |
46791.52 |
Total Medical Medicare Standardized Payment Amount |
47780.87 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
173 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
356 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
253 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
202 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7961 |