National Provider Identifier [NPI]: |
1841511672 |
Last Name Of The Provider |
YOUSSEF |
First Name Of The Provider |
EHAB |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 EAST MEDICAL CENTER DR |
Street Address 2 Of The Provider |
B1 FLOOR UNIVERSITY HOSPITAL RECP C |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481095030 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
92 |
Number Of Services |
19161 |
Number Of Medicare Beneficiaries |
728 |
Total Submitted Charge Amount |
608832.5 |
Total Medicare Allowed Amount |
233648.85 |
Total Medicare Payment Amount |
182500 |
Total Medicare Standardized Payment Amount |
188616.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
17936 |
Number Of Medicare Beneficiaries With Drug Services |
191 |
Total Drug Submitted ChargeAmount |
8812 |
Total Drug Medicare AllowedAmount |
4553.4 |
Total Drug Medicare PaymentAmount |
3512.39 |
Total Drug Medicare Standardized Payment Amount |
3512.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
1225 |
Number Of Medicare Beneficiaries With Medical Services |
728 |
Total Medical Submitted Charge Amount |
600020.5 |
Total Medical Medicare Allowed Amount |
229095.45 |
Total Medical Medicare Payment Amount |
178987.61 |
Total Medical Medicare Standardized Payment Amount |
185103.86 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
307 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
395 |
Number Of Male Beneficiaries |
333 |
Number Of Non Hispanic White Beneficiaries |
600 |
Number Of Black or African American Beneficiaries |
103 |
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 |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
597 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8655 |