National Provider Identifier [NPI]: |
1528050424 |
Last Name Of The Provider |
ELLIOTT |
First Name Of The Provider |
LUKE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22646 E 9 MILE RD |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
ST CLAIR SHORES |
Zip Code Of The Provider |
480801951 |
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 |
52 |
Number Of Services |
1243 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
107540 |
Total Medicare Allowed Amount |
77034.54 |
Total Medicare Payment Amount |
55859.75 |
Total Medicare Standardized Payment Amount |
55045.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
196 |
Number Of Medicare Beneficiaries With Drug Services |
88 |
Total Drug Submitted ChargeAmount |
3948 |
Total Drug Medicare AllowedAmount |
1652.38 |
Total Drug Medicare PaymentAmount |
1547.97 |
Total Drug Medicare Standardized Payment Amount |
1547.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
1047 |
Number Of Medicare Beneficiaries With Medical Services |
241 |
Total Medical Submitted Charge Amount |
103592 |
Total Medical Medicare Allowed Amount |
75382.16 |
Total Medical Medicare Payment Amount |
54311.78 |
Total Medical Medicare Standardized Payment Amount |
53497.52 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
220 |
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 |
220 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3188 |