National Provider Identifier [NPI]: |
1245436583 |
Last Name Of The Provider |
JURADO |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 SAINT ANTOINE ST |
Street Address 2 Of The Provider |
WSU-DMC DEPARTMENT OF ANESTHESOLOGY, DRH-UHC, 3T |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012153 |
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 |
57 |
Number Of Services |
580 |
Number Of Medicare Beneficiaries |
490 |
Total Submitted Charge Amount |
534792 |
Total Medicare Allowed Amount |
57740.02 |
Total Medicare Payment Amount |
44415.93 |
Total Medicare Standardized Payment Amount |
42909.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
59 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1335 |
Total Drug Medicare AllowedAmount |
14.63 |
Total Drug Medicare PaymentAmount |
11.48 |
Total Drug Medicare Standardized Payment Amount |
11.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
521 |
Number Of Medicare Beneficiaries With Medical Services |
490 |
Total Medical Submitted Charge Amount |
533457 |
Total Medical Medicare Allowed Amount |
57725.39 |
Total Medical Medicare Payment Amount |
44404.45 |
Total Medical Medicare Standardized Payment Amount |
42897.79 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
331 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
89 |
Number Of Black or African American Beneficiaries |
382 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
262 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1426 |