National Provider Identifier [NPI]: |
1619924644 |
Last Name Of The Provider |
DIMITRIJEVSKI |
First Name Of The Provider |
TRIFUN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 SAINT ANTOINE ST |
Street Address 2 Of The Provider |
SUITE 3R |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012153 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
520 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
275146 |
Total Medicare Allowed Amount |
54014.48 |
Total Medicare Payment Amount |
41612.14 |
Total Medicare Standardized Payment Amount |
40081.51 |
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 |
21 |
Number Of Medical Services |
520 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
275146 |
Total Medical Medicare Allowed Amount |
54014.48 |
Total Medical Medicare Payment Amount |
41612.14 |
Total Medical Medicare Standardized Payment Amount |
40081.51 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
34 |
Number Of Black or African American Beneficiaries |
284 |
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 |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
245 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.5296 |