National Provider Identifier [NPI]: |
1083621510 |
Last Name Of The Provider |
BEST |
First Name Of The Provider |
MICHAEL |
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 |
8865 W 400 N |
Street Address 2 Of The Provider |
|
City Of The Provider |
MICHIGAN CITY |
Zip Code Of The Provider |
463609222 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1765 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
191112 |
Total Medicare Allowed Amount |
136961.19 |
Total Medicare Payment Amount |
97618.51 |
Total Medicare Standardized Payment Amount |
104260.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
165 |
Number Of Medicare Beneficiaries With Drug Services |
113 |
Total Drug Submitted ChargeAmount |
6525 |
Total Drug Medicare AllowedAmount |
4253.08 |
Total Drug Medicare PaymentAmount |
4147.77 |
Total Drug Medicare Standardized Payment Amount |
4147.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
1600 |
Number Of Medicare Beneficiaries With Medical Services |
284 |
Total Medical Submitted Charge Amount |
184587 |
Total Medical Medicare Allowed Amount |
132708.11 |
Total Medical Medicare Payment Amount |
93470.74 |
Total Medical Medicare Standardized Payment Amount |
100112.44 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0068 |