National Provider Identifier [NPI]: |
1467425595 |
Last Name Of The Provider |
HARIMOTO |
First Name Of The Provider |
DEANE |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 W 13 MILE RD |
Street Address 2 Of The Provider |
ANESTHESIOLOGY DEPT |
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
48073 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
701 |
Number Of Medicare Beneficiaries |
661 |
Total Submitted Charge Amount |
753691 |
Total Medicare Allowed Amount |
69974.28 |
Total Medicare Payment Amount |
53788.92 |
Total Medicare Standardized Payment Amount |
52974.78 |
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 |
78 |
Number Of Medical Services |
701 |
Number Of Medicare Beneficiaries With Medical Services |
661 |
Total Medical Submitted Charge Amount |
753691 |
Total Medical Medicare Allowed Amount |
69974.28 |
Total Medical Medicare Payment Amount |
53788.92 |
Total Medical Medicare Standardized Payment Amount |
52974.78 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
264 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
294 |
Number Of Non Hispanic White Beneficiaries |
614 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
577 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7053 |