| National Provider Identifier [NPI]: | 1326049032 |
| Last Name Of The Provider | IP |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 405 W GREENLAWN AVE |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | LANSING |
| Zip Code Of The Provider | 489102898 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 5843 |
| Number Of Medicare Beneficiaries | 2724 |
| Total Submitted Charge Amount | 741784.53 |
| Total Medicare Allowed Amount | 340396.7 |
| Total Medicare Payment Amount | 250597.51 |
| Total Medicare Standardized Payment Amount | 259504.4 |
| 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 | 73 |
| Number Of Medical Services | 5843 |
| Number Of Medicare Beneficiaries With Medical Services | 2724 |
| Total Medical Submitted Charge Amount | 741784.53 |
| Total Medical Medicare Allowed Amount | 340396.7 |
| Total Medical Medicare Payment Amount | 250597.51 |
| Total Medical Medicare Standardized Payment Amount | 259504.4 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 331 |
| Number Of Beneficiaries Age 65 to 74 | 810 |
| Number Of Beneficiaries Age 75 to 84 | 939 |
| Number Of Beneficiaries Age Greater 84 | 644 |
| Number Of Female Beneficiaries | 1301 |
| Number Of Male Beneficiaries | 1423 |
| Number Of Non Hispanic White Beneficiaries | 2461 |
| Number Of Black or African American Beneficiaries | 151 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 442 |
| Percent Of With Atrial Fibrillation | 41 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7417 |