National Provider Identifier [NPI]: |
1144479148 |
Last Name Of The Provider |
GORMAS |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 E MICHIGAN AVE STE 725 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANSING |
Zip Code Of The Provider |
489121832 |
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 |
18 |
Number Of Services |
621 |
Number Of Medicare Beneficiaries |
292 |
Total Submitted Charge Amount |
78241 |
Total Medicare Allowed Amount |
35417.49 |
Total Medicare Payment Amount |
27070.91 |
Total Medicare Standardized Payment Amount |
33161.22 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
146 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
249 |
Number Of Black or African American Beneficiaries |
23 |
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 |
240 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6865 |