National Provider Identifier [NPI]: |
1861485500 |
Last Name Of The Provider |
ELANJIAN |
First Name Of The Provider |
MARCEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2151 MONROE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DEARBORN |
Zip Code Of The Provider |
481242922 |
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 |
61 |
Number Of Services |
7301 |
Number Of Medicare Beneficiaries |
440 |
Total Submitted Charge Amount |
726205.61 |
Total Medicare Allowed Amount |
599047.14 |
Total Medicare Payment Amount |
467689.22 |
Total Medicare Standardized Payment Amount |
457139.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
101 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
5080 |
Total Drug Medicare AllowedAmount |
1547.2 |
Total Drug Medicare PaymentAmount |
1516.07 |
Total Drug Medicare Standardized Payment Amount |
1516.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
7200 |
Number Of Medicare Beneficiaries With Medical Services |
440 |
Total Medical Submitted Charge Amount |
721125.61 |
Total Medical Medicare Allowed Amount |
597499.94 |
Total Medical Medicare Payment Amount |
466173.15 |
Total Medical Medicare Standardized Payment Amount |
455623.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
198 |
Number Of Non Hispanic White Beneficiaries |
329 |
Number Of Black or African American Beneficiaries |
84 |
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.5143 |