| National Provider Identifier [NPI]: | 1982713640 |
| Last Name Of The Provider | HODDINOTT |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4005 ORCHARD DR |
| Street Address 2 Of The Provider | MID MICHIGAN MEDICAL CENTER |
| City Of The Provider | MIDLAND |
| Zip Code Of The Provider | 486700001 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 3325 |
| Number Of Medicare Beneficiaries | 1642 |
| Total Submitted Charge Amount | 258021 |
| Total Medicare Allowed Amount | 106200.72 |
| Total Medicare Payment Amount | 82110.29 |
| Total Medicare Standardized Payment Amount | 67755.98 |
| 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 | 27 |
| Number Of Medical Services | 3325 |
| Number Of Medicare Beneficiaries With Medical Services | 1642 |
| Total Medical Submitted Charge Amount | 258021 |
| Total Medical Medicare Allowed Amount | 106200.72 |
| Total Medical Medicare Payment Amount | 82110.29 |
| Total Medical Medicare Standardized Payment Amount | 67755.98 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 343 |
| Number Of Beneficiaries Age 65 to 74 | 661 |
| Number Of Beneficiaries Age 75 to 84 | 449 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 864 |
| Number Of Male Beneficiaries | 778 |
| Number Of Non Hispanic White Beneficiaries | 1595 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1278 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 364 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3934 |