| National Provider Identifier [NPI]: | 1467406439 |
| Last Name Of The Provider | HEIDELBERG |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18510 MEYERS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482351307 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 5578 |
| Number Of Medicare Beneficiaries | 1109 |
| Total Submitted Charge Amount | 491203 |
| Total Medicare Allowed Amount | 351895.5 |
| Total Medicare Payment Amount | 252265 |
| Total Medicare Standardized Payment Amount | 245867.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 235 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 1405 |
| Total Drug Medicare AllowedAmount | 419.56 |
| Total Drug Medicare PaymentAmount | 289.25 |
| Total Drug Medicare Standardized Payment Amount | 289.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 5343 |
| Number Of Medicare Beneficiaries With Medical Services | 1109 |
| Total Medical Submitted Charge Amount | 489798 |
| Total Medical Medicare Allowed Amount | 351475.94 |
| Total Medical Medicare Payment Amount | 251975.75 |
| Total Medical Medicare Standardized Payment Amount | 245578.24 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 368 |
| Number Of Beneficiaries Age 65 to 74 | 456 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 849 |
| Number Of Male Beneficiaries | 260 |
| Number Of Non Hispanic White Beneficiaries | 22 |
| Number Of Black or African American Beneficiaries | 1075 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 407 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3943 |