National Provider Identifier [NPI]: |
1457581589 |
Last Name Of The Provider |
SOLANO |
First Name Of The Provider |
ROY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
44405 WOODWARD AVE |
Street Address 2 Of The Provider |
ATTN: EMERGENCY DEPARTMENT ADMINISTRATION |
City Of The Provider |
PONTIAC |
Zip Code Of The Provider |
483415023 |
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 |
50 |
Number Of Services |
1212 |
Number Of Medicare Beneficiaries |
854 |
Total Submitted Charge Amount |
981414 |
Total Medicare Allowed Amount |
153875.38 |
Total Medicare Payment Amount |
117712.05 |
Total Medicare Standardized Payment Amount |
119949.95 |
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 |
50 |
Number Of Medical Services |
1212 |
Number Of Medicare Beneficiaries With Medical Services |
854 |
Total Medical Submitted Charge Amount |
981414 |
Total Medical Medicare Allowed Amount |
153875.38 |
Total Medical Medicare Payment Amount |
117712.05 |
Total Medical Medicare Standardized Payment Amount |
119949.95 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
233 |
Number Of Beneficiaries Age 65 to 74 |
251 |
Number Of Beneficiaries Age 75 to 84 |
215 |
Number Of Beneficiaries Age Greater 84 |
155 |
Number Of Female Beneficiaries |
498 |
Number Of Male Beneficiaries |
356 |
Number Of Non Hispanic White Beneficiaries |
503 |
Number Of Black or African American Beneficiaries |
232 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
89 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
557 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
297 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3964 |