National Provider Identifier [NPI]: |
1851356976 |
Last Name Of The Provider |
HADDLESEY |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5333 MCAULEY DR |
Street Address 2 Of The Provider |
SUITE 6016 |
City Of The Provider |
YPSILANTI |
Zip Code Of The Provider |
481971014 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
141 |
Number Of Services |
7512 |
Number Of Medicare Beneficiaries |
4774 |
Total Submitted Charge Amount |
454545 |
Total Medicare Allowed Amount |
173785.79 |
Total Medicare Payment Amount |
136595.98 |
Total Medicare Standardized Payment Amount |
133834.66 |
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 |
141 |
Number Of Medical Services |
7512 |
Number Of Medicare Beneficiaries With Medical Services |
4774 |
Total Medical Submitted Charge Amount |
454545 |
Total Medical Medicare Allowed Amount |
173785.79 |
Total Medical Medicare Payment Amount |
136595.98 |
Total Medical Medicare Standardized Payment Amount |
133834.66 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
706 |
Number Of Beneficiaries Age 65 to 74 |
1877 |
Number Of Beneficiaries Age 75 to 84 |
1357 |
Number Of Beneficiaries Age Greater 84 |
834 |
Number Of Female Beneficiaries |
3402 |
Number Of Male Beneficiaries |
1372 |
Number Of Non Hispanic White Beneficiaries |
4242 |
Number Of Black or African American Beneficiaries |
335 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
81 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
64 |
Number Of Beneficiaries With Medicare Only Entitlement |
3945 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
829 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5606 |