| National Provider Identifier [NPI]: | 1740476621 |
| Last Name Of The Provider | ROUHANI |
| First Name Of The Provider | MARJANEH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 363 FREMONT ST |
| Street Address 2 Of The Provider | 300 |
| City Of The Provider | BATTLE CREEK |
| Zip Code Of The Provider | 490173389 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 5978 |
| Number Of Medicare Beneficiaries | 251 |
| Total Submitted Charge Amount | 713373 |
| Total Medicare Allowed Amount | 491846.6 |
| Total Medicare Payment Amount | 378671.03 |
| Total Medicare Standardized Payment Amount | 391891.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 5978 |
| Number Of Medicare Beneficiaries With Medical Services | 251 |
| Total Medical Submitted Charge Amount | 713373 |
| Total Medical Medicare Allowed Amount | 491846.6 |
| Total Medical Medicare Payment Amount | 378671.03 |
| Total Medical Medicare Standardized Payment Amount | 391891.12 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 216 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 45 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4117 |