| National Provider Identifier [NPI]: | 1669429106 |
| Last Name Of The Provider | RUTH |
| First Name Of The Provider | SHAWN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 707 S GREENVILLE WEST DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENVILLE |
| Zip Code Of The Provider | 488383514 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 4658 |
| Number Of Medicare Beneficiaries | 687 |
| Total Submitted Charge Amount | 529040 |
| Total Medicare Allowed Amount | 284324.67 |
| Total Medicare Payment Amount | 213435.44 |
| Total Medicare Standardized Payment Amount | 221369.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1444 |
| Number Of Medicare Beneficiaries With Drug Services | 206 |
| Total Drug Submitted ChargeAmount | 15005 |
| Total Drug Medicare AllowedAmount | 8528.14 |
| Total Drug Medicare PaymentAmount | 7599.8 |
| Total Drug Medicare Standardized Payment Amount | 7599.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 3214 |
| Number Of Medicare Beneficiaries With Medical Services | 687 |
| Total Medical Submitted Charge Amount | 514035 |
| Total Medical Medicare Allowed Amount | 275796.53 |
| Total Medical Medicare Payment Amount | 205835.64 |
| Total Medical Medicare Standardized Payment Amount | 213769.39 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 259 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 120 |
| Number Of Female Beneficiaries | 395 |
| Number Of Male Beneficiaries | 292 |
| Number Of Non Hispanic White Beneficiaries | 667 |
| Number Of Black or African American Beneficiaries | |
| 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 | 527 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5431 |