National Provider Identifier [NPI]: |
1114095650 |
Last Name Of The Provider |
GREWAL |
First Name Of The Provider |
MONIKA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2799 W GRAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482022608 |
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 |
23 |
Number Of Services |
331 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
40525 |
Total Medicare Allowed Amount |
28847.42 |
Total Medicare Payment Amount |
20723.42 |
Total Medicare Standardized Payment Amount |
20165.15 |
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 |
23 |
Number Of Medical Services |
331 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
40525 |
Total Medical Medicare Allowed Amount |
28847.42 |
Total Medical Medicare Payment Amount |
20723.42 |
Total Medical Medicare Standardized Payment Amount |
20165.15 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
129 |
Number Of Black or African American Beneficiaries |
28 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1932 |