| National Provider Identifier [NPI]: | 1396769378 |
| Last Name Of The Provider | SELIS |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6245 INKSTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GARDEN CITY |
| Zip Code Of The Provider | 481354001 |
| 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 | 208 |
| Number Of Services | 10437 |
| Number Of Medicare Beneficiaries | 5031 |
| Total Submitted Charge Amount | 713369.15 |
| Total Medicare Allowed Amount | 290299.72 |
| Total Medicare Payment Amount | 228268.59 |
| Total Medicare Standardized Payment Amount | 223365.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2072 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 896 |
| Total Drug Medicare AllowedAmount | 439.65 |
| Total Drug Medicare PaymentAmount | 344.7 |
| Total Drug Medicare Standardized Payment Amount | 344.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 206 |
| Number Of Medical Services | 8365 |
| Number Of Medicare Beneficiaries With Medical Services | 5031 |
| Total Medical Submitted Charge Amount | 712473.15 |
| Total Medical Medicare Allowed Amount | 289860.07 |
| Total Medical Medicare Payment Amount | 227923.89 |
| Total Medical Medicare Standardized Payment Amount | 223020.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 967 |
| Number Of Beneficiaries Age 65 to 74 | 1951 |
| Number Of Beneficiaries Age 75 to 84 | 1346 |
| Number Of Beneficiaries Age Greater 84 | 767 |
| Number Of Female Beneficiaries | 3519 |
| Number Of Male Beneficiaries | 1512 |
| Number Of Non Hispanic White Beneficiaries | 2760 |
| Number Of Black or African American Beneficiaries | 2138 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3840 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1191 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8062 |