National Provider Identifier [NPI]: |
1336189513 |
Last Name Of The Provider |
FREGENE |
First Name Of The Provider |
TOSAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20770 GREENFIELD RD |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
OAK PARK |
Zip Code Of The Provider |
482373018 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
19162 |
Number Of Medicare Beneficiaries |
741 |
Total Submitted Charge Amount |
1163047.4 |
Total Medicare Allowed Amount |
798005.42 |
Total Medicare Payment Amount |
619458.61 |
Total Medicare Standardized Payment Amount |
607351.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
33 |
Number Of Drug Services |
13755 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
537793.4 |
Total Drug Medicare AllowedAmount |
338340.98 |
Total Drug Medicare PaymentAmount |
264879 |
Total Drug Medicare Standardized Payment Amount |
264879 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
5407 |
Number Of Medicare Beneficiaries With Medical Services |
741 |
Total Medical Submitted Charge Amount |
625254 |
Total Medical Medicare Allowed Amount |
459664.44 |
Total Medical Medicare Payment Amount |
354579.61 |
Total Medical Medicare Standardized Payment Amount |
342472.97 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
195 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
208 |
Number Of Beneficiaries Age Greater 84 |
95 |
Number Of Female Beneficiaries |
456 |
Number Of Male Beneficiaries |
285 |
Number Of Non Hispanic White Beneficiaries |
23 |
Number Of Black or African American Beneficiaries |
706 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
354 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
387 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
42 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.7698 |