| National Provider Identifier [NPI]: | 1912089897 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095054 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 3614 |
| Number Of Medicare Beneficiaries | 1787 |
| Total Submitted Charge Amount | 312663 |
| Total Medicare Allowed Amount | 72464.18 |
| Total Medicare Payment Amount | 53487.5 |
| Total Medicare Standardized Payment Amount | 51857.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 3614 |
| Number Of Medicare Beneficiaries With Medical Services | 1787 |
| Total Medical Submitted Charge Amount | 312663 |
| Total Medical Medicare Allowed Amount | 72464.18 |
| Total Medical Medicare Payment Amount | 53487.5 |
| Total Medical Medicare Standardized Payment Amount | 51857.54 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 399 |
| Number Of Beneficiaries Age 65 to 74 | 788 |
| Number Of Beneficiaries Age 75 to 84 | 447 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 975 |
| Number Of Male Beneficiaries | 812 |
| Number Of Non Hispanic White Beneficiaries | 1465 |
| Number Of Black or African American Beneficiaries | 190 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 318 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8016 |