National Provider Identifier [NPI]: |
1427084292 |
Last Name Of The Provider |
COLEMAN |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18161 W 13 MILE RD |
Street Address 2 Of The Provider |
SUITE A-2 |
City Of The Provider |
SOUTHFIELD |
Zip Code Of The Provider |
480761113 |
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 |
17 |
Number Of Services |
354 |
Number Of Medicare Beneficiaries |
307 |
Total Submitted Charge Amount |
194982 |
Total Medicare Allowed Amount |
41858.74 |
Total Medicare Payment Amount |
31871.97 |
Total Medicare Standardized Payment Amount |
32526.93 |
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 |
17 |
Number Of Medical Services |
354 |
Number Of Medicare Beneficiaries With Medical Services |
307 |
Total Medical Submitted Charge Amount |
194982 |
Total Medical Medicare Allowed Amount |
41858.74 |
Total Medical Medicare Payment Amount |
31871.97 |
Total Medical Medicare Standardized Payment Amount |
32526.93 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
287 |
Number Of Black or African American Beneficiaries |
|
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6816 |