National Provider Identifier [NPI]: |
1295858553 |
Last Name Of The Provider |
KULHANEK |
First Name Of The Provider |
GRACE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 E MICHIGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANSING |
Zip Code Of The Provider |
489121811 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1073 |
Number Of Medicare Beneficiaries |
387 |
Total Submitted Charge Amount |
103927 |
Total Medicare Allowed Amount |
72860.04 |
Total Medicare Payment Amount |
53308.07 |
Total Medicare Standardized Payment Amount |
54937.78 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
33 |
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 |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2987 |