National Provider Identifier [NPI]: |
1063768984 |
Last Name Of The Provider |
TSEKOS |
First Name Of The Provider |
IOANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
26237 SOUTHFIELD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LATHRUP VILLAGE |
Zip Code Of The Provider |
480764546 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1527 |
Number Of Medicare Beneficiaries |
477 |
Total Submitted Charge Amount |
257744 |
Total Medicare Allowed Amount |
138013.32 |
Total Medicare Payment Amount |
95125.48 |
Total Medicare Standardized Payment Amount |
112929.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
215 |
Total Drug Medicare AllowedAmount |
199.98 |
Total Drug Medicare PaymentAmount |
195.63 |
Total Drug Medicare Standardized Payment Amount |
195.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
1512 |
Number Of Medicare Beneficiaries With Medical Services |
477 |
Total Medical Submitted Charge Amount |
257529 |
Total Medical Medicare Allowed Amount |
137813.34 |
Total Medical Medicare Payment Amount |
94929.85 |
Total Medical Medicare Standardized Payment Amount |
112734.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
229 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
394 |
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 |
386 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
59 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.5019 |