| National Provider Identifier [NPI]: | 1881881324 |
| Last Name Of The Provider | PEDRAZA |
| First Name Of The Provider | EDGARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1547 S WAYNE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WESTLAND |
| Zip Code Of The Provider | 481865436 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1557 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 181745.08 |
| Total Medicare Allowed Amount | 100541.09 |
| Total Medicare Payment Amount | 72589.64 |
| Total Medicare Standardized Payment Amount | 70915.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 206 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 3223.2 |
| Total Drug Medicare AllowedAmount | 2737.85 |
| Total Drug Medicare PaymentAmount | 2025.61 |
| Total Drug Medicare Standardized Payment Amount | 2025.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1351 |
| Number Of Medicare Beneficiaries With Medical Services | 254 |
| Total Medical Submitted Charge Amount | 178521.88 |
| Total Medical Medicare Allowed Amount | 97803.24 |
| Total Medical Medicare Payment Amount | 70564.03 |
| Total Medical Medicare Standardized Payment Amount | 68889.42 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 206 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 190 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 65 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 56 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3215 |