National Provider Identifier [NPI]: |
1518902345 |
Last Name Of The Provider |
AMIRIKIA |
First Name Of The Provider |
AREZO |
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 |
44555 WOODWARD AVE |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
PONTIAC |
Zip Code Of The Provider |
483415031 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
6729 |
Number Of Medicare Beneficiaries |
1135 |
Total Submitted Charge Amount |
1465362 |
Total Medicare Allowed Amount |
863567.41 |
Total Medicare Payment Amount |
654470.38 |
Total Medicare Standardized Payment Amount |
646659.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
79 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
42297 |
Total Drug Medicare AllowedAmount |
35242.77 |
Total Drug Medicare PaymentAmount |
27515.09 |
Total Drug Medicare Standardized Payment Amount |
27515.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
6650 |
Number Of Medicare Beneficiaries With Medical Services |
1135 |
Total Medical Submitted Charge Amount |
1423065 |
Total Medical Medicare Allowed Amount |
828324.64 |
Total Medical Medicare Payment Amount |
626955.29 |
Total Medical Medicare Standardized Payment Amount |
619144.24 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
457 |
Number Of Beneficiaries Age 75 to 84 |
366 |
Number Of Beneficiaries Age Greater 84 |
210 |
Number Of Female Beneficiaries |
682 |
Number Of Male Beneficiaries |
453 |
Number Of Non Hispanic White Beneficiaries |
612 |
Number Of Black or African American Beneficiaries |
450 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
987 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
148 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.474 |