National Provider Identifier [NPI]: |
1609823921 |
Last Name Of The Provider |
BENSON |
First Name Of The Provider |
DON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17717 MASONIC |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRASER |
Zip Code Of The Provider |
480263158 |
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 |
39 |
Number Of Services |
1325 |
Number Of Medicare Beneficiaries |
793 |
Total Submitted Charge Amount |
425766.51 |
Total Medicare Allowed Amount |
140457.58 |
Total Medicare Payment Amount |
108197.9 |
Total Medicare Standardized Payment Amount |
103511.51 |
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 |
39 |
Number Of Medical Services |
1325 |
Number Of Medicare Beneficiaries With Medical Services |
793 |
Total Medical Submitted Charge Amount |
425766.51 |
Total Medical Medicare Allowed Amount |
140457.58 |
Total Medical Medicare Payment Amount |
108197.9 |
Total Medical Medicare Standardized Payment Amount |
103511.51 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
283 |
Number Of Beneficiaries Age 65 to 74 |
204 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
462 |
Number Of Male Beneficiaries |
331 |
Number Of Non Hispanic White Beneficiaries |
333 |
Number Of Black or African American Beneficiaries |
446 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
442 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
351 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.6688 |