National Provider Identifier [NPI]: |
1255317178 |
Last Name Of The Provider |
JAMES |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5312 LAPEER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KIMBALL |
Zip Code Of The Provider |
480741424 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
4110 |
Number Of Medicare Beneficiaries |
531 |
Total Submitted Charge Amount |
247547.6 |
Total Medicare Allowed Amount |
171526.12 |
Total Medicare Payment Amount |
122239.43 |
Total Medicare Standardized Payment Amount |
126816.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
1071 |
Number Of Medicare Beneficiaries With Drug Services |
210 |
Total Drug Submitted ChargeAmount |
26813.6 |
Total Drug Medicare AllowedAmount |
12725.67 |
Total Drug Medicare PaymentAmount |
10815.94 |
Total Drug Medicare Standardized Payment Amount |
10815.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
3039 |
Number Of Medicare Beneficiaries With Medical Services |
531 |
Total Medical Submitted Charge Amount |
220734 |
Total Medical Medicare Allowed Amount |
158800.45 |
Total Medical Medicare Payment Amount |
111423.49 |
Total Medical Medicare Standardized Payment Amount |
116000.67 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
93 |
Number Of Beneficiaries Age 65 to 74 |
220 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
515 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
436 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1152 |