National Provider Identifier [NPI]: |
1922176460 |
Last Name Of The Provider |
HAGGINS |
First Name Of The Provider |
DONARD |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2799 W GRAND BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482022608 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
703 |
Number Of Medicare Beneficiaries |
413 |
Total Submitted Charge Amount |
84260 |
Total Medicare Allowed Amount |
64496.17 |
Total Medicare Payment Amount |
44371.7 |
Total Medicare Standardized Payment Amount |
43518.98 |
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 |
17 |
Number Of Medical Services |
703 |
Number Of Medicare Beneficiaries With Medical Services |
413 |
Total Medical Submitted Charge Amount |
84260 |
Total Medical Medicare Allowed Amount |
64496.17 |
Total Medical Medicare Payment Amount |
44371.7 |
Total Medical Medicare Standardized Payment Amount |
43518.98 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
151 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
322 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
200 |
Number Of Black or African American Beneficiaries |
190 |
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 |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3572 |