| National Provider Identifier [NPI]: | 1083694830 |
| Last Name Of The Provider | HAKIM |
| First Name Of The Provider | NISHATH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33200 W 14 MILE RD |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | WEST BLOOMFIELD |
| Zip Code Of The Provider | 483223549 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 365 |
| Number Of Medicare Beneficiaries | 88 |
| Total Submitted Charge Amount | 33817.1 |
| Total Medicare Allowed Amount | 25182.04 |
| Total Medicare Payment Amount | 18347.7 |
| Total Medicare Standardized Payment Amount | 17920.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1064.33 |
| Total Drug Medicare AllowedAmount | 553.17 |
| Total Drug Medicare PaymentAmount | 541.14 |
| Total Drug Medicare Standardized Payment Amount | 541.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 337 |
| Number Of Medicare Beneficiaries With Medical Services | 88 |
| Total Medical Submitted Charge Amount | 32752.77 |
| Total Medical Medicare Allowed Amount | 24628.87 |
| Total Medical Medicare Payment Amount | 17806.56 |
| Total Medical Medicare Standardized Payment Amount | 17379.46 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 68 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0501 |