National Provider Identifier [NPI]: |
1851400543 |
Last Name Of The Provider |
SUNDERMANN |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 N 1ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481041397 |
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 |
10 |
Number Of Services |
379 |
Number Of Medicare Beneficiaries |
157 |
Total Submitted Charge Amount |
58356 |
Total Medicare Allowed Amount |
46959.06 |
Total Medicare Payment Amount |
36725.21 |
Total Medicare Standardized Payment Amount |
35552.35 |
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 |
10 |
Number Of Medical Services |
379 |
Number Of Medicare Beneficiaries With Medical Services |
157 |
Total Medical Submitted Charge Amount |
58356 |
Total Medical Medicare Allowed Amount |
46959.06 |
Total Medical Medicare Payment Amount |
36725.21 |
Total Medical Medicare Standardized Payment Amount |
35552.35 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
107 |
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 |
98 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.3122 |