National Provider Identifier [NPI]: |
1972560092 |
Last Name Of The Provider |
PROKOTT |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30200 TELEGRAPH RD |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
BINGHAM FARMS |
Zip Code Of The Provider |
480254502 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
1137 |
Number Of Medicare Beneficiaries |
981 |
Total Submitted Charge Amount |
662105 |
Total Medicare Allowed Amount |
88652.88 |
Total Medicare Payment Amount |
68254.51 |
Total Medicare Standardized Payment Amount |
69320.29 |
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 |
79 |
Number Of Medical Services |
1137 |
Number Of Medicare Beneficiaries With Medical Services |
981 |
Total Medical Submitted Charge Amount |
662105 |
Total Medical Medicare Allowed Amount |
88652.88 |
Total Medical Medicare Payment Amount |
68254.51 |
Total Medical Medicare Standardized Payment Amount |
69320.29 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
466 |
Number Of Beneficiaries Age 75 to 84 |
295 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
545 |
Number Of Male Beneficiaries |
436 |
Number Of Non Hispanic White Beneficiaries |
847 |
Number Of Black or African American Beneficiaries |
100 |
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 |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
841 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3158 |