| National Provider Identifier [NPI]: | 1841209426 |
| Last Name Of The Provider | GAIKAZIAN |
| First Name Of The Provider | SUSANNA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3577 WEST THIRTEEN MILE ROAD |
| Street Address 2 Of The Provider | STE 404 |
| City Of The Provider | ROYAL OAK |
| Zip Code Of The Provider | 48073 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 65694 |
| Number Of Medicare Beneficiaries | 888 |
| Total Submitted Charge Amount | 1476153.95 |
| Total Medicare Allowed Amount | 1103506.31 |
| Total Medicare Payment Amount | 864595.88 |
| Total Medicare Standardized Payment Amount | 857285.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 61 |
| Number Of Drug Services | 59931 |
| Number Of Medicare Beneficiaries With Drug Services | 193 |
| Total Drug Submitted ChargeAmount | 1024710.85 |
| Total Drug Medicare AllowedAmount | 812221.2 |
| Total Drug Medicare PaymentAmount | 635250.89 |
| Total Drug Medicare Standardized Payment Amount | 635250.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 5763 |
| Number Of Medicare Beneficiaries With Medical Services | 888 |
| Total Medical Submitted Charge Amount | 451443.1 |
| Total Medical Medicare Allowed Amount | 291285.11 |
| Total Medical Medicare Payment Amount | 229344.99 |
| Total Medical Medicare Standardized Payment Amount | 222034.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 560 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 680 |
| Number Of Black or African American Beneficiaries | 172 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 742 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 44 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.4113 |