National Provider Identifier [NPI]: |
1225000292 |
Last Name Of The Provider |
EMERY |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
555 MIDTOWNE ST NE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495035729 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
2082 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
184288 |
Total Medicare Allowed Amount |
110988.38 |
Total Medicare Payment Amount |
77325.04 |
Total Medicare Standardized Payment Amount |
80199.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
9226 |
Total Drug Medicare AllowedAmount |
8729.1 |
Total Drug Medicare PaymentAmount |
6176.55 |
Total Drug Medicare Standardized Payment Amount |
6176.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2041 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
175062 |
Total Medical Medicare Allowed Amount |
102259.28 |
Total Medical Medicare Payment Amount |
71148.49 |
Total Medical Medicare Standardized Payment Amount |
74022.85 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
275 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
271 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9424 |