National Provider Identifier [NPI]: |
1891708590 |
Last Name Of The Provider |
GIELCZYK |
First Name Of The Provider |
ROBERT |
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 |
6225 PRAIRIE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTON SHORES |
Zip Code Of The Provider |
494447831 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
96 |
Number Of Services |
11388 |
Number Of Medicare Beneficiaries |
1835 |
Total Submitted Charge Amount |
1118980 |
Total Medicare Allowed Amount |
672934.38 |
Total Medicare Payment Amount |
490278.33 |
Total Medicare Standardized Payment Amount |
497940.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
59 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
14880 |
Total Drug Medicare AllowedAmount |
14122.88 |
Total Drug Medicare PaymentAmount |
10726.56 |
Total Drug Medicare Standardized Payment Amount |
10726.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
11329 |
Number Of Medicare Beneficiaries With Medical Services |
1835 |
Total Medical Submitted Charge Amount |
1104100 |
Total Medical Medicare Allowed Amount |
658811.5 |
Total Medical Medicare Payment Amount |
479551.77 |
Total Medical Medicare Standardized Payment Amount |
487213.56 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
707 |
Number Of Beneficiaries Age 75 to 84 |
677 |
Number Of Beneficiaries Age Greater 84 |
296 |
Number Of Female Beneficiaries |
942 |
Number Of Male Beneficiaries |
893 |
Number Of Non Hispanic White Beneficiaries |
1775 |
Number Of Black or African American Beneficiaries |
25 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1702 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0313 |