National Provider Identifier [NPI]: |
1144296153 |
Last Name Of The Provider |
USEN |
First Name Of The Provider |
NSIMA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM, MPH, FACFAS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1628 FORD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WYANDOTTE |
Zip Code Of The Provider |
481922304 |
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 |
109 |
Number Of Services |
6661 |
Number Of Medicare Beneficiaries |
1117 |
Total Submitted Charge Amount |
780048 |
Total Medicare Allowed Amount |
483139.03 |
Total Medicare Payment Amount |
377152.32 |
Total Medicare Standardized Payment Amount |
365647.69 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
355 |
Number Of Beneficiaries Age 65 to 74 |
348 |
Number Of Beneficiaries Age 75 to 84 |
221 |
Number Of Beneficiaries Age Greater 84 |
193 |
Number Of Female Beneficiaries |
590 |
Number Of Male Beneficiaries |
527 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
833 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
487 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
630 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
3.5743 |