| National Provider Identifier [NPI]: | 1093770349 |
| Last Name Of The Provider | HAQUE |
| First Name Of The Provider | RAFIA |
| 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 | 14551 SOUTHFIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALLEN PARK |
| Zip Code Of The Provider | 481012687 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1679 |
| Number Of Medicare Beneficiaries | 136 |
| Total Submitted Charge Amount | 164507.36 |
| Total Medicare Allowed Amount | 116114.74 |
| Total Medicare Payment Amount | 85107.79 |
| Total Medicare Standardized Payment Amount | 83052.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 190 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 3964 |
| Total Drug Medicare AllowedAmount | 1601.36 |
| Total Drug Medicare PaymentAmount | 1529.6 |
| Total Drug Medicare Standardized Payment Amount | 1529.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1489 |
| Number Of Medicare Beneficiaries With Medical Services | 136 |
| Total Medical Submitted Charge Amount | 160543.36 |
| Total Medical Medicare Allowed Amount | 114513.38 |
| Total Medical Medicare Payment Amount | 83578.19 |
| Total Medical Medicare Standardized Payment Amount | 81523.29 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | 101 |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3197 |