National Provider Identifier [NPI]: |
1235259458 |
Last Name Of The Provider |
CHAKEL |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 E MEDICAL CENTER DR |
Street Address 2 Of The Provider |
B1-380 TC |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481090999 |
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 |
24 |
Number Of Services |
744 |
Number Of Medicare Beneficiaries |
674 |
Total Submitted Charge Amount |
728149 |
Total Medicare Allowed Amount |
125554.72 |
Total Medicare Payment Amount |
96680.26 |
Total Medicare Standardized Payment Amount |
92654.39 |
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 |
24 |
Number Of Medical Services |
744 |
Number Of Medicare Beneficiaries With Medical Services |
674 |
Total Medical Submitted Charge Amount |
728149 |
Total Medical Medicare Allowed Amount |
125554.72 |
Total Medical Medicare Payment Amount |
96680.26 |
Total Medical Medicare Standardized Payment Amount |
92654.39 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
207 |
Number Of Female Beneficiaries |
429 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
569 |
Number Of Black or African American Beneficiaries |
84 |
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 |
501 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
173 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.2701 |