| National Provider Identifier [NPI]: | 1740221522 |
| Last Name Of The Provider | PEROV |
| First Name Of The Provider | SAMUEL |
| 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 | 4160 JOHN R ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482012021 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 2493 |
| Number Of Medicare Beneficiaries | 477 |
| Total Submitted Charge Amount | 1248314 |
| Total Medicare Allowed Amount | 170174.64 |
| Total Medicare Payment Amount | 128111.89 |
| Total Medicare Standardized Payment Amount | 122651.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1143 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 40840 |
| Total Drug Medicare AllowedAmount | 1274.73 |
| Total Drug Medicare PaymentAmount | 980.52 |
| Total Drug Medicare Standardized Payment Amount | 980.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 1350 |
| Number Of Medicare Beneficiaries With Medical Services | 477 |
| Total Medical Submitted Charge Amount | 1207474 |
| Total Medical Medicare Allowed Amount | 168899.91 |
| Total Medical Medicare Payment Amount | 127131.37 |
| Total Medical Medicare Standardized Payment Amount | 121670.97 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 236 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| Number Of Black or African American Beneficiaries | 325 |
| 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 | 156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 321 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.125 |