| National Provider Identifier [NPI]: | 1871538314 |
| Last Name Of The Provider | CAVENAGH |
| First Name Of The Provider | ELLEN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 E MICHIGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LANSING |
| Zip Code Of The Provider | 489121811 |
| 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 | 129 |
| Number Of Services | 8191 |
| Number Of Medicare Beneficiaries | 4467 |
| Total Submitted Charge Amount | 423906 |
| Total Medicare Allowed Amount | 210893.18 |
| Total Medicare Payment Amount | 158140.32 |
| Total Medicare Standardized Payment Amount | 164695.78 |
| 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 | 129 |
| Number Of Medical Services | 8191 |
| Number Of Medicare Beneficiaries With Medical Services | 4467 |
| Total Medical Submitted Charge Amount | 423906 |
| Total Medical Medicare Allowed Amount | 210893.18 |
| Total Medical Medicare Payment Amount | 158140.32 |
| Total Medical Medicare Standardized Payment Amount | 164695.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1173 |
| Number Of Beneficiaries Age 65 to 74 | 1313 |
| Number Of Beneficiaries Age 75 to 84 | 1169 |
| Number Of Beneficiaries Age Greater 84 | 812 |
| Number Of Female Beneficiaries | 2557 |
| Number Of Male Beneficiaries | 1910 |
| Number Of Non Hispanic White Beneficiaries | 3764 |
| Number Of Black or African American Beneficiaries | 443 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3028 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1439 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7784 |