National Provider Identifier [NPI]: |
1972513265 |
Last Name Of The Provider |
DORSTEN |
First Name Of The Provider |
JANICE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6245 INKSTER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GARDEN CITY |
Zip Code Of The Provider |
481354001 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
1204 |
Number Of Medicare Beneficiaries |
1076 |
Total Submitted Charge Amount |
859089 |
Total Medicare Allowed Amount |
131188.7 |
Total Medicare Payment Amount |
99851.71 |
Total Medicare Standardized Payment Amount |
95510.37 |
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 |
58 |
Number Of Medical Services |
1204 |
Number Of Medicare Beneficiaries With Medical Services |
1076 |
Total Medical Submitted Charge Amount |
859089 |
Total Medical Medicare Allowed Amount |
131188.7 |
Total Medical Medicare Payment Amount |
99851.71 |
Total Medical Medicare Standardized Payment Amount |
95510.37 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
140 |
Number Of Beneficiaries Age 65 to 74 |
555 |
Number Of Beneficiaries Age 75 to 84 |
299 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
635 |
Number Of Male Beneficiaries |
441 |
Number Of Non Hispanic White Beneficiaries |
848 |
Number Of Black or African American Beneficiaries |
161 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
846 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
230 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
6 |
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 |
1.4086 |