National Provider Identifier [NPI]: |
1043488893 |
Last Name Of The Provider |
SMARK |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 W 13 MILE RD |
Street Address 2 Of The Provider |
DEPARTMENT OF EMERGENCY MEDICINE |
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
480736712 |
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 |
27 |
Number Of Services |
559 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
131029 |
Total Medicare Allowed Amount |
84021.87 |
Total Medicare Payment Amount |
64918.26 |
Total Medicare Standardized Payment Amount |
62430.93 |
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 |
27 |
Number Of Medical Services |
559 |
Number Of Medicare Beneficiaries With Medical Services |
506 |
Total Medical Submitted Charge Amount |
131029 |
Total Medical Medicare Allowed Amount |
84021.87 |
Total Medical Medicare Payment Amount |
64918.26 |
Total Medical Medicare Standardized Payment Amount |
62430.93 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
101 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
366 |
Number Of Black or African American Beneficiaries |
118 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
359 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.3328 |