National Provider Identifier [NPI]: |
1235334871 |
Last Name Of The Provider |
KAGALWALLA |
First Name Of The Provider |
ABID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 E MEDICAL CENTER DR |
Street Address 2 Of The Provider |
B1-380 TC, SPC 5305 |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481090999 |
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 |
26 |
Number Of Services |
710 |
Number Of Medicare Beneficiaries |
501 |
Total Submitted Charge Amount |
572176 |
Total Medicare Allowed Amount |
92633.6 |
Total Medicare Payment Amount |
70699.99 |
Total Medicare Standardized Payment Amount |
72664 |
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 |
26 |
Number Of Medical Services |
710 |
Number Of Medicare Beneficiaries With Medical Services |
501 |
Total Medical Submitted Charge Amount |
572176 |
Total Medical Medicare Allowed Amount |
92633.6 |
Total Medical Medicare Payment Amount |
70699.99 |
Total Medical Medicare Standardized Payment Amount |
72664 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
289 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
313 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
159 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9118 |