| National Provider Identifier [NPI]: | 1134320898 |
| Last Name Of The Provider | VOHRA |
| First Name Of The Provider | SAIFUDDIN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11800 E 12 MILE RD |
| Street Address 2 Of The Provider | ST. JOHN MACOMB HOSPITAL |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 480933472 |
| 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 | 163 |
| Number Of Services | 5447 |
| Number Of Medicare Beneficiaries | 3372 |
| Total Submitted Charge Amount | 370103.54 |
| Total Medicare Allowed Amount | 177231.97 |
| Total Medicare Payment Amount | 136597.9 |
| Total Medicare Standardized Payment Amount | 132511.17 |
| 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 | 163 |
| Number Of Medical Services | 5447 |
| Number Of Medicare Beneficiaries With Medical Services | 3372 |
| Total Medical Submitted Charge Amount | 370103.54 |
| Total Medical Medicare Allowed Amount | 177231.97 |
| Total Medical Medicare Payment Amount | 136597.9 |
| Total Medical Medicare Standardized Payment Amount | 132511.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 769 |
| Number Of Beneficiaries Age 65 to 74 | 923 |
| Number Of Beneficiaries Age 75 to 84 | 933 |
| Number Of Beneficiaries Age Greater 84 | 747 |
| Number Of Female Beneficiaries | 2051 |
| Number Of Male Beneficiaries | 1321 |
| Number Of Non Hispanic White Beneficiaries | 2711 |
| Number Of Black or African American Beneficiaries | 526 |
| Number Of AsianPacific Islander Beneficiaries | 58 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1139 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3286 |