National Provider Identifier [NPI]: |
1306931068 |
Last Name Of The Provider |
GRAHAM |
First Name Of The Provider |
DAVID |
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 |
27550 SCHOENHERR RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
WARREN |
Zip Code Of The Provider |
480884798 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
16859 |
Number Of Medicare Beneficiaries |
1393 |
Total Submitted Charge Amount |
1221304.5 |
Total Medicare Allowed Amount |
703974.61 |
Total Medicare Payment Amount |
564033.58 |
Total Medicare Standardized Payment Amount |
556178.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
515 |
Number Of Medicare Beneficiaries With Drug Services |
243 |
Total Drug Submitted ChargeAmount |
29330 |
Total Drug Medicare AllowedAmount |
22076.58 |
Total Drug Medicare PaymentAmount |
18618.64 |
Total Drug Medicare Standardized Payment Amount |
18618.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
114 |
Number Of Medical Services |
16344 |
Number Of Medicare Beneficiaries With Medical Services |
1393 |
Total Medical Submitted Charge Amount |
1191974.5 |
Total Medical Medicare Allowed Amount |
681898.03 |
Total Medical Medicare Payment Amount |
545414.94 |
Total Medical Medicare Standardized Payment Amount |
537559.42 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
216 |
Number Of Beneficiaries Age 65 to 74 |
393 |
Number Of Beneficiaries Age 75 to 84 |
445 |
Number Of Beneficiaries Age Greater 84 |
339 |
Number Of Female Beneficiaries |
732 |
Number Of Male Beneficiaries |
661 |
Number Of Non Hispanic White Beneficiaries |
1018 |
Number Of Black or African American Beneficiaries |
339 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1090 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
303 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.248 |