National Provider Identifier [NPI]: |
1861593055 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7120 CLEARVISTA DR |
Street Address 2 Of The Provider |
SUITE 2100 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462561621 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1332 |
Number Of Medicare Beneficiaries |
418 |
Total Submitted Charge Amount |
304140.5 |
Total Medicare Allowed Amount |
155825.76 |
Total Medicare Payment Amount |
118506.23 |
Total Medicare Standardized Payment Amount |
125238.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
679 |
Total Drug Medicare AllowedAmount |
472.27 |
Total Drug Medicare PaymentAmount |
462.8 |
Total Drug Medicare Standardized Payment Amount |
462.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
1321 |
Number Of Medicare Beneficiaries With Medical Services |
418 |
Total Medical Submitted Charge Amount |
303461.5 |
Total Medical Medicare Allowed Amount |
155353.49 |
Total Medical Medicare Payment Amount |
118043.43 |
Total Medical Medicare Standardized Payment Amount |
124775.27 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
251 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
330 |
Number Of Black or African American Beneficiaries |
72 |
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 |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
58 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4136 |