National Provider Identifier [NPI]: |
1912096702 |
Last Name Of The Provider |
RAHAL |
First Name Of The Provider |
PEGGY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30117 SCHOENHERR RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
WARREN |
Zip Code Of The Provider |
480886854 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
2934 |
Number Of Medicare Beneficiaries |
997 |
Total Submitted Charge Amount |
609785.6 |
Total Medicare Allowed Amount |
388736.72 |
Total Medicare Payment Amount |
300329.12 |
Total Medicare Standardized Payment Amount |
292756.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
273 |
Total Drug Medicare AllowedAmount |
160.18 |
Total Drug Medicare PaymentAmount |
132.3 |
Total Drug Medicare Standardized Payment Amount |
132.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
2908 |
Number Of Medicare Beneficiaries With Medical Services |
997 |
Total Medical Submitted Charge Amount |
609512.6 |
Total Medical Medicare Allowed Amount |
388576.54 |
Total Medical Medicare Payment Amount |
300196.82 |
Total Medical Medicare Standardized Payment Amount |
292624.23 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
192 |
Number Of Beneficiaries Age 65 to 74 |
326 |
Number Of Beneficiaries Age 75 to 84 |
295 |
Number Of Beneficiaries Age Greater 84 |
184 |
Number Of Female Beneficiaries |
551 |
Number Of Male Beneficiaries |
446 |
Number Of Non Hispanic White Beneficiaries |
846 |
Number Of Black or African American Beneficiaries |
111 |
Number Of AsianPacific Islander Beneficiaries |
18 |
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 |
713 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
284 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
73 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.6197 |