National Provider Identifier [NPI]: |
1952456816 |
Last Name Of The Provider |
CRAIG |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
826 W KING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OWOSSO |
Zip Code Of The Provider |
488672120 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
655 |
Number Of Medicare Beneficiaries |
543 |
Total Submitted Charge Amount |
530525 |
Total Medicare Allowed Amount |
88351.62 |
Total Medicare Payment Amount |
68231.39 |
Total Medicare Standardized Payment Amount |
69075.07 |
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 |
17 |
Number Of Medical Services |
655 |
Number Of Medicare Beneficiaries With Medical Services |
543 |
Total Medical Submitted Charge Amount |
530525 |
Total Medical Medicare Allowed Amount |
88351.62 |
Total Medical Medicare Payment Amount |
68231.39 |
Total Medical Medicare Standardized Payment Amount |
69075.07 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
171 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
103 |
Number Of Female Beneficiaries |
333 |
Number Of Male Beneficiaries |
210 |
Number Of Non Hispanic White Beneficiaries |
529 |
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 |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
228 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6382 |