National Provider Identifier [NPI]: |
1184618811 |
Last Name Of The Provider |
GRODMAN |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3055 HILTON RD |
Street Address 2 Of The Provider |
STE C |
City Of The Provider |
FERNDALE |
Zip Code Of The Provider |
482201096 |
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 |
57 |
Number Of Services |
3455 |
Number Of Medicare Beneficiaries |
695 |
Total Submitted Charge Amount |
275996.63 |
Total Medicare Allowed Amount |
186512.09 |
Total Medicare Payment Amount |
138225.93 |
Total Medicare Standardized Payment Amount |
135426.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
336 |
Number Of Medicare Beneficiaries With Drug Services |
136 |
Total Drug Submitted ChargeAmount |
1194 |
Total Drug Medicare AllowedAmount |
168.53 |
Total Drug Medicare PaymentAmount |
130.31 |
Total Drug Medicare Standardized Payment Amount |
130.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
3119 |
Number Of Medicare Beneficiaries With Medical Services |
695 |
Total Medical Submitted Charge Amount |
274802.63 |
Total Medical Medicare Allowed Amount |
186343.56 |
Total Medical Medicare Payment Amount |
138095.62 |
Total Medical Medicare Standardized Payment Amount |
135296.33 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
199 |
Number Of Female Beneficiaries |
445 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
576 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
508 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8442 |