| National Provider Identifier [NPI]: | 1134103732 |
| Last Name Of The Provider | KEY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5900 BYRON CENTER AVE SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | WYOMING |
| Zip Code Of The Provider | 495199606 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 3118 |
| Number Of Medicare Beneficiaries | 1245 |
| Total Submitted Charge Amount | 432301.48 |
| Total Medicare Allowed Amount | 229280.92 |
| Total Medicare Payment Amount | 172719.46 |
| Total Medicare Standardized Payment Amount | 179934.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 293 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 49615 |
| Total Drug Medicare AllowedAmount | 9180.87 |
| Total Drug Medicare PaymentAmount | 7105.33 |
| Total Drug Medicare Standardized Payment Amount | 7105.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 2825 |
| Number Of Medicare Beneficiaries With Medical Services | 1245 |
| Total Medical Submitted Charge Amount | 382686.48 |
| Total Medical Medicare Allowed Amount | 220100.05 |
| Total Medical Medicare Payment Amount | 165614.13 |
| Total Medical Medicare Standardized Payment Amount | 172829.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 421 |
| Number Of Beneficiaries Age 75 to 84 | 363 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 606 |
| Number Of Non Hispanic White Beneficiaries | 1124 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 936 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 309 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7469 |