National Provider Identifier [NPI]: |
1952381816 |
Last Name Of The Provider |
WEST |
First Name Of The Provider |
EVAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PSY.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20010 FARMINGTON RD |
Street Address 2 Of The Provider |
BLDG F |
City Of The Provider |
LIVONIA |
Zip Code Of The Provider |
481521408 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
766 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
131400 |
Total Medicare Allowed Amount |
78523.38 |
Total Medicare Payment Amount |
60763.97 |
Total Medicare Standardized Payment Amount |
58681.55 |
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 |
10 |
Number Of Medical Services |
766 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
131400 |
Total Medical Medicare Allowed Amount |
78523.38 |
Total Medical Medicare Payment Amount |
60763.97 |
Total Medical Medicare Standardized Payment Amount |
58681.55 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
223 |
Number Of Black or African American Beneficiaries |
|
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.6739 |