| National Provider Identifier [NPI]: | 1528099801 |
| Last Name Of The Provider | SHAPIRO |
| First Name Of The Provider | ELI |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 HARRINGTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT CLEMENS |
| Zip Code Of The Provider | 480432920 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 8966 |
| Number Of Medicare Beneficiaries | 4174 |
| Total Submitted Charge Amount | 558426.79 |
| Total Medicare Allowed Amount | 234998.76 |
| Total Medicare Payment Amount | 183141.62 |
| Total Medicare Standardized Payment Amount | 179436.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 8966 |
| Number Of Medicare Beneficiaries With Medical Services | 4174 |
| Total Medical Submitted Charge Amount | 558426.79 |
| Total Medical Medicare Allowed Amount | 234998.76 |
| Total Medical Medicare Payment Amount | 183141.62 |
| Total Medical Medicare Standardized Payment Amount | 179436.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1037 |
| Number Of Beneficiaries Age 65 to 74 | 1397 |
| Number Of Beneficiaries Age 75 to 84 | 1046 |
| Number Of Beneficiaries Age Greater 84 | 694 |
| Number Of Female Beneficiaries | 2454 |
| Number Of Male Beneficiaries | 1720 |
| Number Of Non Hispanic White Beneficiaries | 3651 |
| Number Of Black or African American Beneficiaries | 406 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2998 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1176 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0116 |