National Provider Identifier [NPI]: |
1730207614 |
Last Name Of The Provider |
OTENG |
First Name Of The Provider |
ROCKEFELLER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HURLEY PLAZA |
Street Address 2 Of The Provider |
SON 5TH FLOOR |
City Of The Provider |
FLINT |
Zip Code Of The Provider |
48503 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
540 |
Number Of Medicare Beneficiaries |
323 |
Total Submitted Charge Amount |
92525 |
Total Medicare Allowed Amount |
41279.17 |
Total Medicare Payment Amount |
31864.29 |
Total Medicare Standardized Payment Amount |
32037.95 |
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 |
25 |
Number Of Medical Services |
540 |
Number Of Medicare Beneficiaries With Medical Services |
323 |
Total Medical Submitted Charge Amount |
92525 |
Total Medical Medicare Allowed Amount |
41279.17 |
Total Medical Medicare Payment Amount |
31864.29 |
Total Medical Medicare Standardized Payment Amount |
32037.95 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
171 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
170 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
201 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.7998 |