National Provider Identifier [NPI]: |
1467555953 |
Last Name Of The Provider |
MIKS |
First Name Of The Provider |
VERONICA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11800 E 12 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARREN |
Zip Code Of The Provider |
480933472 |
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 |
33 |
Number Of Services |
2074 |
Number Of Medicare Beneficiaries |
1060 |
Total Submitted Charge Amount |
677892.95 |
Total Medicare Allowed Amount |
223167.78 |
Total Medicare Payment Amount |
171783.67 |
Total Medicare Standardized Payment Amount |
165943.16 |
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 |
33 |
Number Of Medical Services |
2074 |
Number Of Medicare Beneficiaries With Medical Services |
1060 |
Total Medical Submitted Charge Amount |
677892.95 |
Total Medical Medicare Allowed Amount |
223167.78 |
Total Medical Medicare Payment Amount |
171783.67 |
Total Medical Medicare Standardized Payment Amount |
165943.16 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
237 |
Number Of Beneficiaries Age 75 to 84 |
288 |
Number Of Beneficiaries Age Greater 84 |
288 |
Number Of Female Beneficiaries |
665 |
Number Of Male Beneficiaries |
395 |
Number Of Non Hispanic White Beneficiaries |
850 |
Number Of Black or African American Beneficiaries |
179 |
Number Of AsianPacific Islander Beneficiaries |
11 |
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 |
710 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
350 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4099 |