National Provider Identifier [NPI]: |
1104853126 |
Last Name Of The Provider |
SCHLEGA |
First Name Of The Provider |
MEKETA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1540 LAKE LANSING RD |
Street Address 2 Of The Provider |
SUITE 107 |
City Of The Provider |
LANSING |
Zip Code Of The Provider |
489123756 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
131 |
Number Of Services |
8906 |
Number Of Medicare Beneficiaries |
1333 |
Total Submitted Charge Amount |
490482.47 |
Total Medicare Allowed Amount |
182095.93 |
Total Medicare Payment Amount |
148486.93 |
Total Medicare Standardized Payment Amount |
158956.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
6834 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
5164.47 |
Total Drug Medicare AllowedAmount |
2198.16 |
Total Drug Medicare PaymentAmount |
1723 |
Total Drug Medicare Standardized Payment Amount |
1723 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
128 |
Number Of Medical Services |
2072 |
Number Of Medicare Beneficiaries With Medical Services |
1333 |
Total Medical Submitted Charge Amount |
485318 |
Total Medical Medicare Allowed Amount |
179897.77 |
Total Medical Medicare Payment Amount |
146763.93 |
Total Medical Medicare Standardized Payment Amount |
157233.49 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
640 |
Number Of Beneficiaries Age 75 to 84 |
401 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
995 |
Number Of Male Beneficiaries |
338 |
Number Of Non Hispanic White Beneficiaries |
1161 |
Number Of Black or African American Beneficiaries |
103 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
1197 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1202 |