| National Provider Identifier [NPI]: | 1386634749 |
| Last Name Of The Provider | DEITCH |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 37450 DEQUINDRE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STERLING HEIGHTS |
| Zip Code Of The Provider | 483103503 |
| 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 | 80 |
| Number Of Services | 4724 |
| Number Of Medicare Beneficiaries | 961 |
| Total Submitted Charge Amount | 556669 |
| Total Medicare Allowed Amount | 352440.31 |
| Total Medicare Payment Amount | 269710.5 |
| Total Medicare Standardized Payment Amount | 263365.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 871 |
| Number Of Medicare Beneficiaries With Drug Services | 178 |
| Total Drug Submitted ChargeAmount | 21104 |
| Total Drug Medicare AllowedAmount | 14915.97 |
| Total Drug Medicare PaymentAmount | 12793.98 |
| Total Drug Medicare Standardized Payment Amount | 12793.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 3853 |
| Number Of Medicare Beneficiaries With Medical Services | 961 |
| Total Medical Submitted Charge Amount | 535565 |
| Total Medical Medicare Allowed Amount | 337524.34 |
| Total Medical Medicare Payment Amount | 256916.52 |
| Total Medical Medicare Standardized Payment Amount | 250571.79 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 225 |
| Number Of Beneficiaries Age 75 to 84 | 315 |
| Number Of Beneficiaries Age Greater 84 | 364 |
| Number Of Female Beneficiaries | 602 |
| Number Of Male Beneficiaries | 359 |
| Number Of Non Hispanic White Beneficiaries | 852 |
| Number Of Black or African American Beneficiaries | 88 |
| 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 | 890 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.7785 |