National Provider Identifier [NPI]: |
1003077207 |
Last Name Of The Provider |
GRIFFITH |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
D |
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 |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
1225 |
Number Of Medicare Beneficiaries |
795 |
Total Submitted Charge Amount |
353301 |
Total Medicare Allowed Amount |
74966.09 |
Total Medicare Payment Amount |
57772.41 |
Total Medicare Standardized Payment Amount |
57288.29 |
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 |
64 |
Number Of Medical Services |
1225 |
Number Of Medicare Beneficiaries With Medical Services |
795 |
Total Medical Submitted Charge Amount |
353301 |
Total Medical Medicare Allowed Amount |
74966.09 |
Total Medical Medicare Payment Amount |
57772.41 |
Total Medical Medicare Standardized Payment Amount |
57288.29 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
200 |
Number Of Beneficiaries Age 65 to 74 |
267 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
134 |
Number Of Female Beneficiaries |
459 |
Number Of Male Beneficiaries |
336 |
Number Of Non Hispanic White Beneficiaries |
401 |
Number Of Black or African American Beneficiaries |
329 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
519 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
276 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
1.8941 |