National Provider Identifier [NPI]: |
1053309393 |
Last Name Of The Provider |
ROECKER |
First Name Of The Provider |
KURT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14930 LAPLAISANCE RD |
Street Address 2 Of The Provider |
SUITE 118 |
City Of The Provider |
MONROE |
Zip Code Of The Provider |
481613880 |
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 |
13 |
Number Of Services |
307 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
38950 |
Total Medicare Allowed Amount |
28708.67 |
Total Medicare Payment Amount |
18497.17 |
Total Medicare Standardized Payment Amount |
19533.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1020 |
Total Drug Medicare AllowedAmount |
455.06 |
Total Drug Medicare PaymentAmount |
437.84 |
Total Drug Medicare Standardized Payment Amount |
437.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
279 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
37930 |
Total Medical Medicare Allowed Amount |
28253.61 |
Total Medical Medicare Payment Amount |
18059.33 |
Total Medical Medicare Standardized Payment Amount |
19095.96 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.953 |