National Provider Identifier [NPI]: |
1033109749 |
Last Name Of The Provider |
HUDOCK |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8244 METROPOLITAN PKWY |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
STERLING HEIGHTS |
Zip Code Of The Provider |
483122778 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
131 |
Number Of Services |
3825 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
198693 |
Total Medicare Allowed Amount |
158701.6 |
Total Medicare Payment Amount |
119555.32 |
Total Medicare Standardized Payment Amount |
118265.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
321 |
Number Of Medicare Beneficiaries With Drug Services |
126 |
Total Drug Submitted ChargeAmount |
7381 |
Total Drug Medicare AllowedAmount |
6496.91 |
Total Drug Medicare PaymentAmount |
5821.84 |
Total Drug Medicare Standardized Payment Amount |
5821.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
118 |
Number Of Medical Services |
3504 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
191312 |
Total Medical Medicare Allowed Amount |
152204.69 |
Total Medical Medicare Payment Amount |
113733.48 |
Total Medical Medicare Standardized Payment Amount |
112443.19 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
302 |
Number Of Black or African American Beneficiaries |
|
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 |
286 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1366 |