| National Provider Identifier [NPI]: | 1689745481 |
| Last Name Of The Provider | ALTARES |
| First Name Of The Provider | EDGAR |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 SOUTH BLVD E |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | ROCHESTER HILLS |
| Zip Code Of The Provider | 483076122 |
| 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 | 76 |
| Number Of Services | 1551 |
| Number Of Medicare Beneficiaries | 640 |
| Total Submitted Charge Amount | 173995 |
| Total Medicare Allowed Amount | 136000.76 |
| Total Medicare Payment Amount | 100714.45 |
| Total Medicare Standardized Payment Amount | 97598.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 2358 |
| Total Drug Medicare AllowedAmount | 1220.77 |
| Total Drug Medicare PaymentAmount | 1157.16 |
| Total Drug Medicare Standardized Payment Amount | 1157.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 1477 |
| Number Of Medicare Beneficiaries With Medical Services | 640 |
| Total Medical Submitted Charge Amount | 171637 |
| Total Medical Medicare Allowed Amount | 134779.99 |
| Total Medical Medicare Payment Amount | 99557.29 |
| Total Medical Medicare Standardized Payment Amount | 96441.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 234 |
| Number Of Beneficiaries Age 75 to 84 | 183 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 423 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 401 |
| Number Of Black or African American Beneficiaries | 215 |
| 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 | 445 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.476 |