| National Provider Identifier [NPI]: | 1750309787 |
| Last Name Of The Provider | SHEVITZ |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 29829 TELEGRAPH RD |
| Street Address 2 Of The Provider | SUITE L103 |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480341330 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 944 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 120770.68 |
| Total Medicare Allowed Amount | 67432.52 |
| Total Medicare Payment Amount | 51933.51 |
| Total Medicare Standardized Payment Amount | 51311.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1976.68 |
| Total Drug Medicare AllowedAmount | 388.87 |
| Total Drug Medicare PaymentAmount | 304.83 |
| Total Drug Medicare Standardized Payment Amount | 304.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 879 |
| Number Of Medicare Beneficiaries With Medical Services | 319 |
| Total Medical Submitted Charge Amount | 118794 |
| Total Medical Medicare Allowed Amount | 67043.65 |
| Total Medical Medicare Payment Amount | 51628.68 |
| Total Medical Medicare Standardized Payment Amount | 51006.67 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 144 |
| Number Of Black or African American Beneficiaries | 154 |
| 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 | 144 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7985 |