| National Provider Identifier [NPI]: | 1548427966 |
| Last Name Of The Provider | SHALHOUB |
| First Name Of The Provider | ALEXANDER |
| 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 | 135 S. PROSPECT |
| Street Address 2 Of The Provider | ROOM 2901 ANESTHESIOLOGY |
| City Of The Provider | YPSILANTI |
| Zip Code Of The Provider | 48198 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 911 |
| Number Of Medicare Beneficiaries | 750 |
| Total Submitted Charge Amount | 655814 |
| Total Medicare Allowed Amount | 101721.94 |
| Total Medicare Payment Amount | 76911.19 |
| Total Medicare Standardized Payment Amount | 73808.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1295 |
| Total Drug Medicare AllowedAmount | 11.54 |
| Total Drug Medicare PaymentAmount | 9.1 |
| Total Drug Medicare Standardized Payment Amount | 9.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 848 |
| Number Of Medicare Beneficiaries With Medical Services | 750 |
| Total Medical Submitted Charge Amount | 654519 |
| Total Medical Medicare Allowed Amount | 101710.4 |
| Total Medical Medicare Payment Amount | 76902.09 |
| Total Medical Medicare Standardized Payment Amount | 73799.3 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 391 |
| Number Of Beneficiaries Age 75 to 84 | 198 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 406 |
| Number Of Male Beneficiaries | 344 |
| Number Of Non Hispanic White Beneficiaries | 684 |
| Number Of Black or African American Beneficiaries | 35 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 686 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2145 |