| National Provider Identifier [NPI]: | 1164476206 |
| Last Name Of The Provider | DIMITRIJEVIC |
| First Name Of The Provider | RODOLJUB |
| 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 | 43421 GARFIELD RD |
| Street Address 2 Of The Provider | STE 1 |
| City Of The Provider | CLINTON TWP |
| Zip Code Of The Provider | 480381133 |
| 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 | 82 |
| Number Of Services | 10192 |
| Number Of Medicare Beneficiaries | 1636 |
| Total Submitted Charge Amount | 564854.5 |
| Total Medicare Allowed Amount | 293278.6 |
| Total Medicare Payment Amount | 222422.22 |
| Total Medicare Standardized Payment Amount | 220110.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 275 |
| Number Of Medicare Beneficiaries With Drug Services | 136 |
| Total Drug Submitted ChargeAmount | 7490 |
| Total Drug Medicare AllowedAmount | 3688.38 |
| Total Drug Medicare PaymentAmount | 3515.52 |
| Total Drug Medicare Standardized Payment Amount | 3515.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 9917 |
| Number Of Medicare Beneficiaries With Medical Services | 1636 |
| Total Medical Submitted Charge Amount | 557364.5 |
| Total Medical Medicare Allowed Amount | 289590.22 |
| Total Medical Medicare Payment Amount | 218906.7 |
| Total Medical Medicare Standardized Payment Amount | 216595.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 501 |
| Number Of Beneficiaries Age 75 to 84 | 542 |
| Number Of Beneficiaries Age Greater 84 | 408 |
| Number Of Female Beneficiaries | 966 |
| Number Of Male Beneficiaries | 670 |
| Number Of Non Hispanic White Beneficiaries | 1494 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1390 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6872 |