National Provider Identifier [NPI]: |
1942378476 |
Last Name Of The Provider |
RAO |
First Name Of The Provider |
SUDHAKER |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
HENRY FORD HEALTH SYSTEM |
Street Address 2 Of The Provider |
3031 WEST GRAND BLVD. |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
48202 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
646 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
105962 |
Total Medicare Allowed Amount |
70750.39 |
Total Medicare Payment Amount |
52345.65 |
Total Medicare Standardized Payment Amount |
50721.16 |
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 |
12 |
Number Of Medical Services |
646 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
105962 |
Total Medical Medicare Allowed Amount |
70750.39 |
Total Medical Medicare Payment Amount |
52345.65 |
Total Medical Medicare Standardized Payment Amount |
50721.16 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
178 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
313 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
185 |
Number Of Black or African American Beneficiaries |
186 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
52 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.1413 |