National Provider Identifier [NPI]: |
1710055264 |
Last Name Of The Provider |
LOUTFI |
First Name Of The Provider |
RANDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
HENRY FORD HEALTH SYSTEM |
Street Address 2 Of The Provider |
2799 WEST GRAND BOULEVARD |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482022608 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
634 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
106499 |
Total Medicare Allowed Amount |
57776.95 |
Total Medicare Payment Amount |
43475.77 |
Total Medicare Standardized Payment Amount |
42041.57 |
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 |
15 |
Number Of Medical Services |
634 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
106499 |
Total Medical Medicare Allowed Amount |
57776.95 |
Total Medical Medicare Payment Amount |
43475.77 |
Total Medical Medicare Standardized Payment Amount |
42041.57 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
88 |
Number Of Black or African American Beneficiaries |
148 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
68 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
2.1092 |