National Provider Identifier [NPI]: |
1548228992 |
Last Name Of The Provider |
CORNETT |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4100 LAKE DR SE |
Street Address 2 Of The Provider |
SUITE 205 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495468292 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
547 |
Number Of Medicare Beneficiaries |
311 |
Total Submitted Charge Amount |
267669 |
Total Medicare Allowed Amount |
93783.17 |
Total Medicare Payment Amount |
72647.55 |
Total Medicare Standardized Payment Amount |
77098.61 |
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 |
53 |
Number Of Medical Services |
547 |
Number Of Medicare Beneficiaries With Medical Services |
311 |
Total Medical Submitted Charge Amount |
267669 |
Total Medical Medicare Allowed Amount |
93783.17 |
Total Medical Medicare Payment Amount |
72647.55 |
Total Medical Medicare Standardized Payment Amount |
77098.61 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
269 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
90 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8459 |