National Provider Identifier [NPI]: |
1609081363 |
Last Name Of The Provider |
FELTON |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 E MICHIGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANSING |
Zip Code Of The Provider |
489121811 |
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 |
28 |
Number Of Services |
848 |
Number Of Medicare Beneficiaries |
518 |
Total Submitted Charge Amount |
428884 |
Total Medicare Allowed Amount |
92685.25 |
Total Medicare Payment Amount |
71050.08 |
Total Medicare Standardized Payment Amount |
71919.36 |
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 |
28 |
Number Of Medical Services |
848 |
Number Of Medicare Beneficiaries With Medical Services |
518 |
Total Medical Submitted Charge Amount |
428884 |
Total Medical Medicare Allowed Amount |
92685.25 |
Total Medical Medicare Payment Amount |
71050.08 |
Total Medical Medicare Standardized Payment Amount |
71919.36 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
197 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
230 |
Number Of Non Hispanic White Beneficiaries |
389 |
Number Of Black or African American Beneficiaries |
82 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
283 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
235 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.2029 |