National Provider Identifier [NPI]: |
1023305224 |
Last Name Of The Provider |
KEIZER |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
28050 GRAND RIVER AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGTON HILLS |
Zip Code Of The Provider |
48336 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
2234 |
Number Of Medicare Beneficiaries |
995 |
Total Submitted Charge Amount |
133220 |
Total Medicare Allowed Amount |
99752.85 |
Total Medicare Payment Amount |
72162.19 |
Total Medicare Standardized Payment Amount |
72612.45 |
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 |
6 |
Number Of Medical Services |
2234 |
Number Of Medicare Beneficiaries With Medical Services |
995 |
Total Medical Submitted Charge Amount |
133220 |
Total Medical Medicare Allowed Amount |
99752.85 |
Total Medical Medicare Payment Amount |
72162.19 |
Total Medical Medicare Standardized Payment Amount |
72612.45 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
269 |
Number Of Beneficiaries Age Greater 84 |
509 |
Number Of Female Beneficiaries |
732 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
716 |
Number Of Black or African American Beneficiaries |
259 |
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 |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
818 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
29 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.6212 |