National Provider Identifier [NPI]: |
1215993514 |
Last Name Of The Provider |
LINK |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
461 W OAK ST |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
KISSIMMEE |
Zip Code Of The Provider |
34741 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
4816 |
Number Of Medicare Beneficiaries |
1120 |
Total Submitted Charge Amount |
275600 |
Total Medicare Allowed Amount |
237044.18 |
Total Medicare Payment Amount |
169818.7 |
Total Medicare Standardized Payment Amount |
175909.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
799 |
Number Of Medicare Beneficiaries With Drug Services |
294 |
Total Drug Submitted ChargeAmount |
12514 |
Total Drug Medicare AllowedAmount |
7299.46 |
Total Drug Medicare PaymentAmount |
6765.47 |
Total Drug Medicare Standardized Payment Amount |
6765.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
4017 |
Number Of Medicare Beneficiaries With Medical Services |
1120 |
Total Medical Submitted Charge Amount |
263086 |
Total Medical Medicare Allowed Amount |
229744.72 |
Total Medical Medicare Payment Amount |
163053.23 |
Total Medical Medicare Standardized Payment Amount |
169143.54 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
215 |
Number Of Beneficiaries Age 65 to 74 |
582 |
Number Of Beneficiaries Age 75 to 84 |
246 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
662 |
Number Of Male Beneficiaries |
458 |
Number Of Non Hispanic White Beneficiaries |
712 |
Number Of Black or African American Beneficiaries |
146 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
221 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
866 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.14 |