| National Provider Identifier [NPI]: | 1144260332 |
| Last Name Of The Provider | ATTY |
| First Name Of The Provider | ED |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 FLECKENSTEIN RD |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 485073042 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 5390.5 |
| Number Of Medicare Beneficiaries | 378 |
| Total Submitted Charge Amount | 2213055.54 |
| Total Medicare Allowed Amount | 298332 |
| Total Medicare Payment Amount | 228770.78 |
| Total Medicare Standardized Payment Amount | 228575.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2371.5 |
| Number Of Medicare Beneficiaries With Drug Services | 184 |
| Total Drug Submitted ChargeAmount | 34990 |
| Total Drug Medicare AllowedAmount | 9400.8 |
| Total Drug Medicare PaymentAmount | 6512.53 |
| Total Drug Medicare Standardized Payment Amount | 6512.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 3019 |
| Number Of Medicare Beneficiaries With Medical Services | 378 |
| Total Medical Submitted Charge Amount | 2178065.54 |
| Total Medical Medicare Allowed Amount | 288931.2 |
| Total Medical Medicare Payment Amount | 222258.25 |
| Total Medical Medicare Standardized Payment Amount | 222062.96 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| Number Of Black or African American Beneficiaries | 53 |
| 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 | 281 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6605 |