| National Provider Identifier [NPI]: | 1881676088 |
| Last Name Of The Provider | ALI |
| First Name Of The Provider | ESA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2590 ELIZABETH LAKE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERFORD |
| Zip Code Of The Provider | 483283314 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 3141 |
| Number Of Medicare Beneficiaries | 969 |
| Total Submitted Charge Amount | 334029.09 |
| Total Medicare Allowed Amount | 251452.68 |
| Total Medicare Payment Amount | 182543.66 |
| Total Medicare Standardized Payment Amount | 180018.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 2711.7 |
| Total Drug Medicare AllowedAmount | 716.11 |
| Total Drug Medicare PaymentAmount | 690.99 |
| Total Drug Medicare Standardized Payment Amount | 690.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 3076 |
| Number Of Medicare Beneficiaries With Medical Services | 967 |
| Total Medical Submitted Charge Amount | 331317.39 |
| Total Medical Medicare Allowed Amount | 250736.57 |
| Total Medical Medicare Payment Amount | 181852.67 |
| Total Medical Medicare Standardized Payment Amount | 179327.94 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 558 |
| Number Of Male Beneficiaries | 411 |
| Number Of Non Hispanic White Beneficiaries | 682 |
| Number Of Black or African American Beneficiaries | 248 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 587 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5941 |