| National Provider Identifier [NPI]: | 1316913304 |
| Last Name Of The Provider | NEDIC |
| First Name Of The Provider | IGOR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3350 GRATIOT BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARYSVILLE |
| Zip Code Of The Provider | 480402121 |
| 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 | 87 |
| Number Of Services | 3246.5 |
| Number Of Medicare Beneficiaries | 214 |
| Total Submitted Charge Amount | 244826.74 |
| Total Medicare Allowed Amount | 149525.26 |
| Total Medicare Payment Amount | 110230.1 |
| Total Medicare Standardized Payment Amount | 115134.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 961.5 |
| Number Of Medicare Beneficiaries With Drug Services | 97 |
| Total Drug Submitted ChargeAmount | 20227.74 |
| Total Drug Medicare AllowedAmount | 14808.58 |
| Total Drug Medicare PaymentAmount | 12327.97 |
| Total Drug Medicare Standardized Payment Amount | 12327.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 2285 |
| Number Of Medicare Beneficiaries With Medical Services | 214 |
| Total Medical Submitted Charge Amount | 224599 |
| Total Medical Medicare Allowed Amount | 134716.68 |
| Total Medical Medicare Payment Amount | 97902.13 |
| Total Medical Medicare Standardized Payment Amount | 102806.07 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 96 |
| 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 | 196 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0727 |