| National Provider Identifier [NPI]: | 1235133703 |
| Last Name Of The Provider | VEREMIS-LEY |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 43900 GARFIELD RD |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | CLINTON TOWNSHIP |
| Zip Code Of The Provider | 480381137 |
| 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 | 77 |
| Number Of Services | 3449 |
| Number Of Medicare Beneficiaries | 755 |
| Total Submitted Charge Amount | 312937.59 |
| Total Medicare Allowed Amount | 209313.79 |
| Total Medicare Payment Amount | 152873 |
| Total Medicare Standardized Payment Amount | 145995.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 820 |
| Total Drug Medicare AllowedAmount | 110.38 |
| Total Drug Medicare PaymentAmount | 83.75 |
| Total Drug Medicare Standardized Payment Amount | 83.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 3396 |
| Number Of Medicare Beneficiaries With Medical Services | 755 |
| Total Medical Submitted Charge Amount | 312117.59 |
| Total Medical Medicare Allowed Amount | 209203.41 |
| Total Medical Medicare Payment Amount | 152789.25 |
| Total Medical Medicare Standardized Payment Amount | 145911.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 488 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 707 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 674 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2372 |