National Provider Identifier [NPI]: |
1386612406 |
Last Name Of The Provider |
ZAWISA |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7575 GRAND RIVER RD |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
BRIGHTON |
Zip Code Of The Provider |
481149309 |
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 |
40 |
Number Of Services |
1386 |
Number Of Medicare Beneficiaries |
389 |
Total Submitted Charge Amount |
135447 |
Total Medicare Allowed Amount |
87875.9 |
Total Medicare Payment Amount |
59803.13 |
Total Medicare Standardized Payment Amount |
64049.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
150 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
3878 |
Total Drug Medicare AllowedAmount |
2734.86 |
Total Drug Medicare PaymentAmount |
2662.2 |
Total Drug Medicare Standardized Payment Amount |
2662.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1236 |
Number Of Medicare Beneficiaries With Medical Services |
389 |
Total Medical Submitted Charge Amount |
131569 |
Total Medical Medicare Allowed Amount |
85141.04 |
Total Medical Medicare Payment Amount |
57140.93 |
Total Medical Medicare Standardized Payment Amount |
61386.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
378 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
353 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9389 |