National Provider Identifier [NPI]: |
1235392580 |
Last Name Of The Provider |
TAYLOR |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4401 N CAMPUS RIDGE DR |
Street Address 2 Of The Provider |
STE C2000 |
City Of The Provider |
MIDLAND |
Zip Code Of The Provider |
486406112 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Sports Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
349 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
45584 |
Total Medicare Allowed Amount |
22359.2 |
Total Medicare Payment Amount |
15904.4 |
Total Medicare Standardized Payment Amount |
16667.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
37 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
2128 |
Total Drug Medicare AllowedAmount |
1667.24 |
Total Drug Medicare PaymentAmount |
1344.34 |
Total Drug Medicare Standardized Payment Amount |
1344.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
312 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
43456 |
Total Medical Medicare Allowed Amount |
20691.96 |
Total Medical Medicare Payment Amount |
14560.06 |
Total Medical Medicare Standardized Payment Amount |
15322.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.981 |