National Provider Identifier [NPI]: |
1437153913 |
Last Name Of The Provider |
METHOD |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5340 HOLY CROSS PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MISHAWAKA |
Zip Code Of The Provider |
465451470 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gynecological/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
181 |
Number Of Services |
179369 |
Number Of Medicare Beneficiaries |
779 |
Total Submitted Charge Amount |
8107800 |
Total Medicare Allowed Amount |
2714719.77 |
Total Medicare Payment Amount |
2103746.34 |
Total Medicare Standardized Payment Amount |
2115457.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
82 |
Number Of Drug Services |
169882 |
Number Of Medicare Beneficiaries With Drug Services |
426 |
Total Drug Submitted ChargeAmount |
5997373 |
Total Drug Medicare AllowedAmount |
2064569.58 |
Total Drug Medicare PaymentAmount |
1605944.41 |
Total Drug Medicare Standardized Payment Amount |
1605944.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
99 |
Number Of Medical Services |
9487 |
Number Of Medicare Beneficiaries With Medical Services |
776 |
Total Medical Submitted Charge Amount |
2110427 |
Total Medical Medicare Allowed Amount |
650150.19 |
Total Medical Medicare Payment Amount |
497801.93 |
Total Medical Medicare Standardized Payment Amount |
509512.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
359 |
Number Of Beneficiaries Age 75 to 84 |
235 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
630 |
Number Of Male Beneficiaries |
149 |
Number Of Non Hispanic White Beneficiaries |
702 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
640 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.8876 |