National Provider Identifier [NPI]: |
1538363999 |
Last Name Of The Provider |
TINIGIN |
First Name Of The Provider |
STANISLAV |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 JOHN ST |
Street Address 2 Of The Provider |
BOX 74 BRONSON INTERNAL MEDICINE SPECIALIST |
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490075341 |
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 |
15 |
Number Of Services |
1324 |
Number Of Medicare Beneficiaries |
637 |
Total Submitted Charge Amount |
204961 |
Total Medicare Allowed Amount |
115415.93 |
Total Medicare Payment Amount |
89534.2 |
Total Medicare Standardized Payment Amount |
92412.16 |
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 |
15 |
Number Of Medical Services |
1324 |
Number Of Medicare Beneficiaries With Medical Services |
637 |
Total Medical Submitted Charge Amount |
204961 |
Total Medical Medicare Allowed Amount |
115415.93 |
Total Medical Medicare Payment Amount |
89534.2 |
Total Medical Medicare Standardized Payment Amount |
92412.16 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
545 |
Number Of Black or African American Beneficiaries |
70 |
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 |
409 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
228 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.2884 |