National Provider Identifier [NPI]: |
1083615488 |
Last Name Of The Provider |
BORDEN |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5315 ELLIOTT DR |
Street Address 2 Of The Provider |
STE 301 |
City Of The Provider |
YPSILANTI |
Zip Code Of The Provider |
481978634 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
824 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
179312 |
Total Medicare Allowed Amount |
82670.66 |
Total Medicare Payment Amount |
61068.7 |
Total Medicare Standardized Payment Amount |
59493.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
144 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
4680 |
Total Drug Medicare AllowedAmount |
2850.92 |
Total Drug Medicare PaymentAmount |
2223.21 |
Total Drug Medicare Standardized Payment Amount |
2223.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
680 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
174632 |
Total Medical Medicare Allowed Amount |
79819.74 |
Total Medical Medicare Payment Amount |
58845.49 |
Total Medical Medicare Standardized Payment Amount |
57270.44 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
219 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.943 |