National Provider Identifier [NPI]: |
1770732414 |
Last Name Of The Provider |
HADLEY |
First Name Of The Provider |
RYAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M. D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4100 LAKE DR SE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495468292 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
590 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
91999 |
Total Medicare Allowed Amount |
39555.3 |
Total Medicare Payment Amount |
29816.47 |
Total Medicare Standardized Payment Amount |
29754.67 |
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 |
26 |
Number Of Medical Services |
590 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
91999 |
Total Medical Medicare Allowed Amount |
39555.3 |
Total Medical Medicare Payment Amount |
29816.47 |
Total Medical Medicare Standardized Payment Amount |
29754.67 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
184 |
Number Of Black or African American Beneficiaries |
23 |
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 |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
20 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
54 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3592 |