National Provider Identifier [NPI]: |
1194782490 |
Last Name Of The Provider |
JIANG |
First Name Of The Provider |
MIN |
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 |
1500 EAST MEDICAL CENTER DR |
Street Address 2 Of The Provider |
3RD FLOOR TAUBMAN CTR RECP B |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481095352 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
654 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
154848 |
Total Medicare Allowed Amount |
73336.01 |
Total Medicare Payment Amount |
56924.09 |
Total Medicare Standardized Payment Amount |
55336.34 |
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 |
12 |
Number Of Medical Services |
654 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
154848 |
Total Medical Medicare Allowed Amount |
73336.01 |
Total Medical Medicare Payment Amount |
56924.09 |
Total Medical Medicare Standardized Payment Amount |
55336.34 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
155 |
Number Of Black or African American Beneficiaries |
37 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
73 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
3.6865 |