National Provider Identifier [NPI]: |
1326023383 |
Last Name Of The Provider |
FRITZ |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 BRADFORD ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495256427 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1669 |
Number Of Medicare Beneficiaries |
1016 |
Total Submitted Charge Amount |
210773 |
Total Medicare Allowed Amount |
107904.16 |
Total Medicare Payment Amount |
77409.47 |
Total Medicare Standardized Payment Amount |
80231.18 |
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 |
34 |
Number Of Medical Services |
1669 |
Number Of Medicare Beneficiaries With Medical Services |
1016 |
Total Medical Submitted Charge Amount |
210773 |
Total Medical Medicare Allowed Amount |
107904.16 |
Total Medical Medicare Payment Amount |
77409.47 |
Total Medical Medicare Standardized Payment Amount |
80231.18 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
170 |
Number Of Beneficiaries Age 65 to 74 |
332 |
Number Of Beneficiaries Age 75 to 84 |
328 |
Number Of Beneficiaries Age Greater 84 |
186 |
Number Of Female Beneficiaries |
479 |
Number Of Male Beneficiaries |
537 |
Number Of Non Hispanic White Beneficiaries |
908 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
780 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
236 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7766 |