National Provider Identifier [NPI]: |
1346218575 |
Last Name Of The Provider |
BAND |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3535 W 13 MILE RD |
Street Address 2 Of The Provider |
STE. 305 |
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
480736710 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
178 |
Number Of Medicare Beneficiaries |
88 |
Total Submitted Charge Amount |
31685 |
Total Medicare Allowed Amount |
22709.05 |
Total Medicare Payment Amount |
17576.1 |
Total Medicare Standardized Payment Amount |
17103.39 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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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 |
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Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
63 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.9709 |