National Provider Identifier [NPI]: |
1235150632 |
Last Name Of The Provider |
MATTHYS |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
24500 NORTHWESTERN HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480752414 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
123 |
Number Of Services |
1460 |
Number Of Medicare Beneficiaries |
650 |
Total Submitted Charge Amount |
367886.5 |
Total Medicare Allowed Amount |
113608.2 |
Total Medicare Payment Amount |
89027.23 |
Total Medicare Standardized Payment Amount |
84747.38 |
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 |
123 |
Number Of Medical Services |
1460 |
Number Of Medicare Beneficiaries With Medical Services |
650 |
Total Medical Submitted Charge Amount |
367886.5 |
Total Medical Medicare Allowed Amount |
113608.2 |
Total Medical Medicare Payment Amount |
89027.23 |
Total Medical Medicare Standardized Payment Amount |
84747.38 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
197 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
380 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
605 |
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 |
274 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
376 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
71 |
Percent Of With Chronic Kidney Disease |
74 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
30 |
Average HCC Risk Score Of Beneficiaries |
4.0213 |