National Provider Identifier [NPI]: |
1053747170 |
Last Name Of The Provider |
CORBA |
First Name Of The Provider |
EMILY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
44201 DEQUINDRE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TROY |
Zip Code Of The Provider |
480851117 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
443 |
Number Of Medicare Beneficiaries |
431 |
Total Submitted Charge Amount |
60148 |
Total Medicare Allowed Amount |
38358.08 |
Total Medicare Payment Amount |
30032.96 |
Total Medicare Standardized Payment Amount |
34152.24 |
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 |
6 |
Number Of Medical Services |
443 |
Number Of Medicare Beneficiaries With Medical Services |
431 |
Total Medical Submitted Charge Amount |
60148 |
Total Medical Medicare Allowed Amount |
38358.08 |
Total Medical Medicare Payment Amount |
30032.96 |
Total Medical Medicare Standardized Payment Amount |
34152.24 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
400 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
361 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.3756 |