National Provider Identifier [NPI]: |
1770659146 |
Last Name Of The Provider |
MCLEAN |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D., PH.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 E MEDICAL CENTER DR |
Street Address 2 Of The Provider |
1ST FLOOR TAUBMAN CTR RECP A |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481095312 |
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 |
85 |
Number Of Services |
747 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
884033 |
Total Medicare Allowed Amount |
231823.41 |
Total Medicare Payment Amount |
181321.44 |
Total Medicare Standardized Payment Amount |
169026.05 |
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 |
85 |
Number Of Medical Services |
747 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
884033 |
Total Medical Medicare Allowed Amount |
231823.41 |
Total Medical Medicare Payment Amount |
181321.44 |
Total Medical Medicare Standardized Payment Amount |
169026.05 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
|
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 |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5631 |