National Provider Identifier [NPI]: |
1013127174 |
Last Name Of The Provider |
JOSEPH |
First Name Of The Provider |
BELLAL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2799 W GRAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482022608 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
487 |
Number Of Medicare Beneficiaries |
227 |
Total Submitted Charge Amount |
281428.8 |
Total Medicare Allowed Amount |
85723.85 |
Total Medicare Payment Amount |
66779.55 |
Total Medicare Standardized Payment Amount |
66930.71 |
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 |
62 |
Number Of Medical Services |
487 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
281428.8 |
Total Medical Medicare Allowed Amount |
85723.85 |
Total Medical Medicare Payment Amount |
66779.55 |
Total Medical Medicare Standardized Payment Amount |
66930.71 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
180 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.8518 |