National Provider Identifier [NPI]: |
1245328772 |
Last Name Of The Provider |
GREENBERG |
First Name Of The Provider |
GRANT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD, MA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14700 EAST OLD US 12 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHELSEA |
Zip Code Of The Provider |
481181185 |
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 |
20 |
Number Of Services |
307 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
30667 |
Total Medicare Allowed Amount |
23955.17 |
Total Medicare Payment Amount |
16771.09 |
Total Medicare Standardized Payment Amount |
16817.33 |
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 |
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Total Drug Medicare Standardized Payment Amount |
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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 |
69 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
152 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.1265 |