| National Provider Identifier [NPI]: | 1194847038 |
| Last Name Of The Provider | LALA |
| First Name Of The Provider | MONIK |
| 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 | 2799 W GRAND BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482022608 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 175 |
| Number Of Services | 17211 |
| Number Of Medicare Beneficiaries | 3484 |
| Total Submitted Charge Amount | 1607413.24 |
| Total Medicare Allowed Amount | 560681.4 |
| Total Medicare Payment Amount | 434117.92 |
| Total Medicare Standardized Payment Amount | 432052.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 11430 |
| Number Of Medicare Beneficiaries With Drug Services | 320 |
| Total Drug Submitted ChargeAmount | 20862.24 |
| Total Drug Medicare AllowedAmount | 8137.77 |
| Total Drug Medicare PaymentAmount | 6380.02 |
| Total Drug Medicare Standardized Payment Amount | 6380.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 5781 |
| Number Of Medicare Beneficiaries With Medical Services | 3484 |
| Total Medical Submitted Charge Amount | 1586551 |
| Total Medical Medicare Allowed Amount | 552543.63 |
| Total Medical Medicare Payment Amount | 427737.9 |
| Total Medical Medicare Standardized Payment Amount | 425672.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 889 |
| Number Of Beneficiaries Age 65 to 74 | 1233 |
| Number Of Beneficiaries Age 75 to 84 | 881 |
| Number Of Beneficiaries Age Greater 84 | 481 |
| Number Of Female Beneficiaries | 2026 |
| Number Of Male Beneficiaries | 1458 |
| Number Of Non Hispanic White Beneficiaries | 1509 |
| Number Of Black or African American Beneficiaries | 1782 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 60 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1157 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9472 |