National Provider Identifier [NPI]: |
1487605531 |
Last Name Of The Provider |
SMENDIK |
First Name Of The Provider |
DOUGLAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
490 EDWARD STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDDLEVILLE |
Zip Code Of The Provider |
49333 |
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 |
27 |
Number Of Services |
855 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
100142 |
Total Medicare Allowed Amount |
73190.25 |
Total Medicare Payment Amount |
51422.02 |
Total Medicare Standardized Payment Amount |
53861.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
79 |
Number Of Medicare Beneficiaries With Drug Services |
76 |
Total Drug Submitted ChargeAmount |
1760 |
Total Drug Medicare AllowedAmount |
1317.5 |
Total Drug Medicare PaymentAmount |
1291.3 |
Total Drug Medicare Standardized Payment Amount |
1291.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
776 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
98382 |
Total Medical Medicare Allowed Amount |
71872.75 |
Total Medical Medicare Payment Amount |
50130.72 |
Total Medical Medicare Standardized Payment Amount |
52570.27 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1364 |