National Provider Identifier [NPI]: |
1538107693 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4160 JOHN R ST |
Street Address 2 Of The Provider |
SUITE 615 |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012020 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
98 |
Number Of Services |
951 |
Number Of Medicare Beneficiaries |
224 |
Total Submitted Charge Amount |
237584 |
Total Medicare Allowed Amount |
106271.37 |
Total Medicare Payment Amount |
82961.24 |
Total Medicare Standardized Payment Amount |
76895.75 |
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 |
98 |
Number Of Medical Services |
951 |
Number Of Medicare Beneficiaries With Medical Services |
224 |
Total Medical Submitted Charge Amount |
237584 |
Total Medical Medicare Allowed Amount |
106271.37 |
Total Medical Medicare Payment Amount |
82961.24 |
Total Medical Medicare Standardized Payment Amount |
76895.75 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
163 |
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 |
92 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.2129 |