National Provider Identifier [NPI]: |
1932189420 |
Last Name Of The Provider |
SHARON |
First Name Of The Provider |
ROBERT |
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 |
1700 BIDDLE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WYANDOTTE |
Zip Code Of The Provider |
481927205 |
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 |
41 |
Number Of Services |
3236 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
388245 |
Total Medicare Allowed Amount |
258465.24 |
Total Medicare Payment Amount |
198594.71 |
Total Medicare Standardized Payment Amount |
195280.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
289 |
Number Of Medicare Beneficiaries With Drug Services |
183 |
Total Drug Submitted ChargeAmount |
8403 |
Total Drug Medicare AllowedAmount |
6166.52 |
Total Drug Medicare PaymentAmount |
6010.87 |
Total Drug Medicare Standardized Payment Amount |
6010.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2947 |
Number Of Medicare Beneficiaries With Medical Services |
506 |
Total Medical Submitted Charge Amount |
379842 |
Total Medical Medicare Allowed Amount |
252298.72 |
Total Medical Medicare Payment Amount |
192583.84 |
Total Medical Medicare Standardized Payment Amount |
189269.17 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
244 |
Number Of Non Hispanic White Beneficiaries |
475 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
477 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1288 |