National Provider Identifier [NPI]: |
1578554424 |
Last Name Of The Provider |
NOWAK |
First Name Of The Provider |
PEGGYANN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6900 ORCHARD LAKE RD |
Street Address 2 Of The Provider |
STE 314 |
City Of The Provider |
WEST BLOOMFIELD |
Zip Code Of The Provider |
48322 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
850 |
Number Of Medicare Beneficiaries |
513 |
Total Submitted Charge Amount |
118742 |
Total Medicare Allowed Amount |
79920.62 |
Total Medicare Payment Amount |
57461.82 |
Total Medicare Standardized Payment Amount |
55681.58 |
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 |
40 |
Number Of Medical Services |
850 |
Number Of Medicare Beneficiaries With Medical Services |
513 |
Total Medical Submitted Charge Amount |
118742 |
Total Medical Medicare Allowed Amount |
79920.62 |
Total Medical Medicare Payment Amount |
57461.82 |
Total Medical Medicare Standardized Payment Amount |
55681.58 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
462 |
Number Of Black or African American Beneficiaries |
28 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
459 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2496 |