National Provider Identifier [NPI]: |
1063642320 |
Last Name Of The Provider |
NEFCY |
First Name Of The Provider |
AIMEE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 ST. ANTOINE BLVD |
Street Address 2 Of The Provider |
|
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 |
52 |
Number Of Services |
335 |
Number Of Medicare Beneficiaries |
190 |
Total Submitted Charge Amount |
105336 |
Total Medicare Allowed Amount |
30031.92 |
Total Medicare Payment Amount |
22262.05 |
Total Medicare Standardized Payment Amount |
21620.79 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
116 |
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 |
75 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1302 |