National Provider Identifier [NPI]: |
1184792624 |
Last Name Of The Provider |
TEJWANI |
First Name Of The Provider |
SHEELA |
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 |
13 |
Number Of Services |
759 |
Number Of Medicare Beneficiaries |
289 |
Total Submitted Charge Amount |
142092 |
Total Medicare Allowed Amount |
76644.81 |
Total Medicare Payment Amount |
57418.99 |
Total Medicare Standardized Payment Amount |
55560.34 |
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 |
13 |
Number Of Medical Services |
759 |
Number Of Medicare Beneficiaries With Medical Services |
289 |
Total Medical Submitted Charge Amount |
142092 |
Total Medical Medicare Allowed Amount |
76644.81 |
Total Medical Medicare Payment Amount |
57418.99 |
Total Medical Medicare Standardized Payment Amount |
55560.34 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
142 |
Number Of Black or African American Beneficiaries |
126 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
66 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.9225 |