National Provider Identifier [NPI]: |
1174776736 |
Last Name Of The Provider |
BRINDAMOUR |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
P.A.-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
28411 NORTHWESTERN HWY |
Street Address 2 Of The Provider |
SUITE 1050 |
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480345544 |
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 |
7 |
Number Of Services |
475 |
Number Of Medicare Beneficiaries |
59 |
Total Submitted Charge Amount |
63857 |
Total Medicare Allowed Amount |
33745.09 |
Total Medicare Payment Amount |
26458.03 |
Total Medicare Standardized Payment Amount |
31971.86 |
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 |
7 |
Number Of Medical Services |
475 |
Number Of Medicare Beneficiaries With Medical Services |
59 |
Total Medical Submitted Charge Amount |
63857 |
Total Medical Medicare Allowed Amount |
33745.09 |
Total Medical Medicare Payment Amount |
26458.03 |
Total Medical Medicare Standardized Payment Amount |
31971.86 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
66 |
Percent Of With Asthma |
29 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
71 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.5071 |