| National Provider Identifier [NPI]: | 1770548232 |
| Last Name Of The Provider | DANESHVAR |
| First Name Of The Provider | HUDSON |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 32950 5 MILE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIVONIA |
| Zip Code Of The Provider | 481546802 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 3679 |
| Number Of Medicare Beneficiaries | 371 |
| Total Submitted Charge Amount | 575220 |
| Total Medicare Allowed Amount | 399914.94 |
| Total Medicare Payment Amount | 307276.1 |
| Total Medicare Standardized Payment Amount | 297753.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 780 |
| Total Drug Medicare AllowedAmount | 284.7 |
| Total Drug Medicare PaymentAmount | 272.68 |
| Total Drug Medicare Standardized Payment Amount | 272.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 3643 |
| Number Of Medicare Beneficiaries With Medical Services | 371 |
| Total Medical Submitted Charge Amount | 574440 |
| Total Medical Medicare Allowed Amount | 399630.24 |
| Total Medical Medicare Payment Amount | 307003.42 |
| Total Medical Medicare Standardized Payment Amount | 297481.11 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 310 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 257 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.5086 |