National Provider Identifier [NPI]: |
1407881543 |
Last Name Of The Provider |
SCHISLER |
First Name Of The Provider |
TESSA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 E VERMONT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAY CITY |
Zip Code Of The Provider |
487064963 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
229 |
Number Of Medicare Beneficiaries |
76 |
Total Submitted Charge Amount |
18541 |
Total Medicare Allowed Amount |
15921.43 |
Total Medicare Payment Amount |
10470.15 |
Total Medicare Standardized Payment Amount |
10981.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
550 |
Total Drug Medicare AllowedAmount |
264.88 |
Total Drug Medicare PaymentAmount |
259.6 |
Total Drug Medicare Standardized Payment Amount |
259.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
207 |
Number Of Medicare Beneficiaries With Medical Services |
76 |
Total Medical Submitted Charge Amount |
17991 |
Total Medical Medicare Allowed Amount |
15656.55 |
Total Medical Medicare Payment Amount |
10210.55 |
Total Medical Medicare Standardized Payment Amount |
10721.79 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
76 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7239 |