National Provider Identifier [NPI]: |
1548225634 |
Last Name Of The Provider |
BLAIR |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5900 BYRON CENTER AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
WYOMING |
Zip Code Of The Provider |
495199606 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1221 |
Number Of Medicare Beneficiaries |
450 |
Total Submitted Charge Amount |
323329 |
Total Medicare Allowed Amount |
148817.52 |
Total Medicare Payment Amount |
112401.24 |
Total Medicare Standardized Payment Amount |
116217.25 |
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 |
17 |
Number Of Medical Services |
1221 |
Number Of Medicare Beneficiaries With Medical Services |
450 |
Total Medical Submitted Charge Amount |
323329 |
Total Medical Medicare Allowed Amount |
148817.52 |
Total Medical Medicare Payment Amount |
112401.24 |
Total Medical Medicare Standardized Payment Amount |
116217.25 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
385 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
263 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1056 |