National Provider Identifier [NPI]: |
1699884429 |
Last Name Of The Provider |
CZARNOTA |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PH.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30055 NORTHWESTERN HWY |
Street Address 2 Of The Provider |
SUITE 30 |
City Of The Provider |
FARMINGTON HILLS |
Zip Code Of The Provider |
483343230 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
499 |
Number Of Medicare Beneficiaries |
345 |
Total Submitted Charge Amount |
117168 |
Total Medicare Allowed Amount |
59116.25 |
Total Medicare Payment Amount |
46054.62 |
Total Medicare Standardized Payment Amount |
39509.63 |
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 |
4 |
Number Of Medical Services |
499 |
Number Of Medicare Beneficiaries With Medical Services |
345 |
Total Medical Submitted Charge Amount |
117168 |
Total Medical Medicare Allowed Amount |
59116.25 |
Total Medical Medicare Payment Amount |
46054.62 |
Total Medical Medicare Standardized Payment Amount |
39509.63 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
235 |
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 |
248 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
52 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.0976 |