| National Provider Identifier [NPI]: | 1225018781 |
| Last Name Of The Provider | LERNER |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 29645 W 14 MILE RD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | FARMINGTON HILLS |
| Zip Code Of The Provider | 483341666 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 176 |
| Number Of Medicare Beneficiaries | 36 |
| Total Submitted Charge Amount | 17737 |
| Total Medicare Allowed Amount | 12830.99 |
| Total Medicare Payment Amount | 9468.17 |
| Total Medicare Standardized Payment Amount | 9247.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 896 |
| Total Drug Medicare AllowedAmount | 677.12 |
| Total Drug Medicare PaymentAmount | 654.86 |
| Total Drug Medicare Standardized Payment Amount | 654.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 151 |
| Number Of Medicare Beneficiaries With Medical Services | 36 |
| Total Medical Submitted Charge Amount | 16841 |
| Total Medical Medicare Allowed Amount | 12153.87 |
| Total Medical Medicare Payment Amount | 8813.31 |
| Total Medical Medicare Standardized Payment Amount | 8592.39 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 23 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| 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 | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4372 |