National Provider Identifier [NPI]: |
1912993759 |
Last Name Of The Provider |
COTTINGHAM |
First Name Of The Provider |
SANDRA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2990 FRANKLIN AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRANDVILLE |
Zip Code Of The Provider |
494183505 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1549 |
Number Of Medicare Beneficiaries |
800 |
Total Submitted Charge Amount |
217782 |
Total Medicare Allowed Amount |
61907.46 |
Total Medicare Payment Amount |
47031.87 |
Total Medicare Standardized Payment Amount |
36107.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
1549 |
Number Of Medicare Beneficiaries With Medical Services |
800 |
Total Medical Submitted Charge Amount |
217782 |
Total Medical Medicare Allowed Amount |
61907.46 |
Total Medical Medicare Payment Amount |
47031.87 |
Total Medical Medicare Standardized Payment Amount |
36107.16 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
197 |
Number Of Beneficiaries Age 65 to 74 |
316 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
423 |
Number Of Male Beneficiaries |
377 |
Number Of Non Hispanic White Beneficiaries |
718 |
Number Of Black or African American Beneficiaries |
48 |
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 |
598 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
202 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4089 |