National Provider Identifier [NPI]: |
1639145634 |
Last Name Of The Provider |
PRATT |
First Name Of The Provider |
JERRY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1722 SHAFFER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490481633 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Thoracic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
528 |
Number Of Medicare Beneficiaries |
222 |
Total Submitted Charge Amount |
774470 |
Total Medicare Allowed Amount |
297481.47 |
Total Medicare Payment Amount |
232634.27 |
Total Medicare Standardized Payment Amount |
236828.99 |
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 |
73 |
Number Of Medical Services |
528 |
Number Of Medicare Beneficiaries With Medical Services |
222 |
Total Medical Submitted Charge Amount |
774470 |
Total Medical Medicare Allowed Amount |
297481.47 |
Total Medical Medicare Payment Amount |
232634.27 |
Total Medical Medicare Standardized Payment Amount |
236828.99 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
208 |
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 |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8337 |