National Provider Identifier [NPI]: |
1508898123 |
Last Name Of The Provider |
MIDDLEBROOK |
First Name Of The Provider |
DEON |
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 |
20176 LIVERNOIS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482211346 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
4445 |
Number Of Medicare Beneficiaries |
347 |
Total Submitted Charge Amount |
995216 |
Total Medicare Allowed Amount |
709144.7 |
Total Medicare Payment Amount |
551256.95 |
Total Medicare Standardized Payment Amount |
534458.97 |
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 |
15 |
Number Of Medical Services |
4445 |
Number Of Medicare Beneficiaries With Medical Services |
347 |
Total Medical Submitted Charge Amount |
995216 |
Total Medical Medicare Allowed Amount |
709144.7 |
Total Medical Medicare Payment Amount |
551256.95 |
Total Medical Medicare Standardized Payment Amount |
534458.97 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
330 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
177 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
70 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
4.5815 |