National Provider Identifier [NPI]: |
1235349234 |
Last Name Of The Provider |
KALAPPARAMBATH |
First Name Of The Provider |
ANNIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
44405 WOODWARD AVE |
Street Address 2 Of The Provider |
ST.JOSEPHMERCYOAKLAND HOSPITAL |
City Of The Provider |
PONTIAC |
Zip Code Of The Provider |
483415023 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
166 |
Number Of Services |
8410 |
Number Of Medicare Beneficiaries |
2209 |
Total Submitted Charge Amount |
699427 |
Total Medicare Allowed Amount |
164124.79 |
Total Medicare Payment Amount |
124564.21 |
Total Medicare Standardized Payment Amount |
122001.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
4555 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
7020 |
Total Drug Medicare AllowedAmount |
2603.1 |
Total Drug Medicare PaymentAmount |
2040.82 |
Total Drug Medicare Standardized Payment Amount |
2040.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
163 |
Number Of Medical Services |
3855 |
Number Of Medicare Beneficiaries With Medical Services |
2209 |
Total Medical Submitted Charge Amount |
692407 |
Total Medical Medicare Allowed Amount |
161521.69 |
Total Medical Medicare Payment Amount |
122523.39 |
Total Medical Medicare Standardized Payment Amount |
119961.15 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
269 |
Number Of Beneficiaries Age 65 to 74 |
822 |
Number Of Beneficiaries Age 75 to 84 |
658 |
Number Of Beneficiaries Age Greater 84 |
460 |
Number Of Female Beneficiaries |
1431 |
Number Of Male Beneficiaries |
778 |
Number Of Non Hispanic White Beneficiaries |
2020 |
Number Of Black or African American Beneficiaries |
82 |
Number Of AsianPacific Islander Beneficiaries |
43 |
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1886 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
323 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7186 |