| National Provider Identifier [NPI]: | 1285659623 |
| Last Name Of The Provider | MIKA |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10415 GRAND RIVER RD |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | BRIGHTON |
| Zip Code Of The Provider | 481166533 |
| 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 | 102 |
| Number Of Services | 3850 |
| Number Of Medicare Beneficiaries | 366 |
| Total Submitted Charge Amount | 248211 |
| Total Medicare Allowed Amount | 155388.59 |
| Total Medicare Payment Amount | 110511.71 |
| Total Medicare Standardized Payment Amount | 119941.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1086 |
| Number Of Medicare Beneficiaries With Drug Services | 200 |
| Total Drug Submitted ChargeAmount | 18711 |
| Total Drug Medicare AllowedAmount | 12916.03 |
| Total Drug Medicare PaymentAmount | 10209.66 |
| Total Drug Medicare Standardized Payment Amount | 10209.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 2764 |
| Number Of Medicare Beneficiaries With Medical Services | 366 |
| Total Medical Submitted Charge Amount | 229500 |
| Total Medical Medicare Allowed Amount | 142472.56 |
| Total Medical Medicare Payment Amount | 100302.05 |
| Total Medical Medicare Standardized Payment Amount | 109731.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 183 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 217 |
| 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 | 350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9989 |