National Provider Identifier [NPI]: |
1750377206 |
Last Name Of The Provider |
PRUITT |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5325 ELLIOTT DR |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
YPSILANTI |
Zip Code Of The Provider |
481978633 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
395 |
Number Of Medicare Beneficiaries |
213 |
Total Submitted Charge Amount |
596161.3 |
Total Medicare Allowed Amount |
339431.31 |
Total Medicare Payment Amount |
265463.16 |
Total Medicare Standardized Payment Amount |
243849.53 |
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 |
51 |
Number Of Medical Services |
395 |
Number Of Medicare Beneficiaries With Medical Services |
213 |
Total Medical Submitted Charge Amount |
596161.3 |
Total Medical Medicare Allowed Amount |
339431.31 |
Total Medical Medicare Payment Amount |
265463.16 |
Total Medical Medicare Standardized Payment Amount |
243849.53 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
202 |
Number Of Black or African American Beneficiaries |
|
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8833 |