National Provider Identifier [NPI]: |
1013907112 |
Last Name Of The Provider |
MLADSI |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4949 COOLIDGE HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
48073 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3475 |
Number Of Medicare Beneficiaries |
1096 |
Total Submitted Charge Amount |
389450 |
Total Medicare Allowed Amount |
194852.66 |
Total Medicare Payment Amount |
144025.72 |
Total Medicare Standardized Payment Amount |
139507.11 |
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 |
27 |
Number Of Medical Services |
3475 |
Number Of Medicare Beneficiaries With Medical Services |
1096 |
Total Medical Submitted Charge Amount |
389450 |
Total Medical Medicare Allowed Amount |
194852.66 |
Total Medical Medicare Payment Amount |
144025.72 |
Total Medical Medicare Standardized Payment Amount |
139507.11 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
400 |
Number Of Beneficiaries Age 75 to 84 |
382 |
Number Of Beneficiaries Age Greater 84 |
238 |
Number Of Female Beneficiaries |
521 |
Number Of Male Beneficiaries |
575 |
Number Of Non Hispanic White Beneficiaries |
935 |
Number Of Black or African American Beneficiaries |
121 |
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 |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
1016 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5796 |