| National Provider Identifier [NPI]: | 1164556692 |
| Last Name Of The Provider | ELLENBERG |
| First Name Of The Provider | MICHAEL |
| 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 | 28455 HAGGERTY RD |
| Street Address 2 Of The Provider | 200 |
| City Of The Provider | NOVI |
| Zip Code Of The Provider | 483772982 |
| 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 | 50 |
| Number Of Services | 7088 |
| Number Of Medicare Beneficiaries | 1215 |
| Total Submitted Charge Amount | 799575.7 |
| Total Medicare Allowed Amount | 425094.53 |
| Total Medicare Payment Amount | 328636.93 |
| Total Medicare Standardized Payment Amount | 317107.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1937 |
| Number Of Medicare Beneficiaries With Drug Services | 312 |
| Total Drug Submitted ChargeAmount | 21620.7 |
| Total Drug Medicare AllowedAmount | 11149.95 |
| Total Drug Medicare PaymentAmount | 8589.34 |
| Total Drug Medicare Standardized Payment Amount | 8589.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 5151 |
| Number Of Medicare Beneficiaries With Medical Services | 1215 |
| Total Medical Submitted Charge Amount | 777955 |
| Total Medical Medicare Allowed Amount | 413944.58 |
| Total Medical Medicare Payment Amount | 320047.59 |
| Total Medical Medicare Standardized Payment Amount | 308518.48 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 394 |
| Number Of Beneficiaries Age Greater 84 | 415 |
| Number Of Female Beneficiaries | 774 |
| Number Of Male Beneficiaries | 441 |
| Number Of Non Hispanic White Beneficiaries | 976 |
| Number Of Black or African American Beneficiaries | 183 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1019 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9516 |