National Provider Identifier [NPI]: |
1811218035 |
Last Name Of The Provider |
KUO |
First Name Of The Provider |
SHINIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 EAST MEDICAL CENTER DRIVE |
Street Address 2 Of The Provider |
3RD FLOOR TAUBMAN CENTER RECP B |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481095352 |
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 |
6 |
Number Of Services |
92 |
Number Of Medicare Beneficiaries |
91 |
Total Submitted Charge Amount |
36672 |
Total Medicare Allowed Amount |
18267.64 |
Total Medicare Payment Amount |
14088.9 |
Total Medicare Standardized Payment Amount |
13581.01 |
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 |
6 |
Number Of Medical Services |
92 |
Number Of Medicare Beneficiaries With Medical Services |
91 |
Total Medical Submitted Charge Amount |
36672 |
Total Medical Medicare Allowed Amount |
18267.64 |
Total Medical Medicare Payment Amount |
14088.9 |
Total Medical Medicare Standardized Payment Amount |
13581.01 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
73 |
Number Of Black or African American Beneficiaries |
|
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 |
61 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
3.0068 |