| National Provider Identifier [NPI]: | 1700197803 |
| Last Name Of The Provider | SAMSEL |
| First Name Of The Provider | RACHEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 31017 JOHN R RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON HEIGHTS |
| Zip Code Of The Provider | 480711907 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 2502 |
| Number Of Medicare Beneficiaries | 630 |
| Total Submitted Charge Amount | 167315 |
| Total Medicare Allowed Amount | 119554.3 |
| Total Medicare Payment Amount | 91043.91 |
| Total Medicare Standardized Payment Amount | 89027.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 405 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 568 |
| Total Drug Medicare AllowedAmount | 123.2 |
| Total Drug Medicare PaymentAmount | 89.15 |
| Total Drug Medicare Standardized Payment Amount | 89.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 2097 |
| Number Of Medicare Beneficiaries With Medical Services | 630 |
| Total Medical Submitted Charge Amount | 166747 |
| Total Medical Medicare Allowed Amount | 119431.1 |
| Total Medical Medicare Payment Amount | 90954.76 |
| Total Medical Medicare Standardized Payment Amount | 88937.97 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 402 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 591 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7174 |