National Provider Identifier [NPI]: |
1144275256 |
Last Name Of The Provider |
RICHARDSON |
First Name Of The Provider |
TODD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5415 FASHION SQUARE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAGINAW |
Zip Code Of The Provider |
486048200 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
918 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
305164 |
Total Medicare Allowed Amount |
155512.21 |
Total Medicare Payment Amount |
120687.77 |
Total Medicare Standardized Payment Amount |
124199.41 |
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 |
86 |
Number Of Medical Services |
918 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
305164 |
Total Medical Medicare Allowed Amount |
155512.21 |
Total Medical Medicare Payment Amount |
120687.77 |
Total Medical Medicare Standardized Payment Amount |
124199.41 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
189 |
Number Of Non Hispanic White Beneficiaries |
331 |
Number Of Black or African American Beneficiaries |
56 |
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 |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7646 |