| National Provider Identifier [NPI]: | 1174566095 |
| Last Name Of The Provider | TRIVAX |
| First Name Of The Provider | JUSTIN |
| 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 | 31500 TELEGRAPH RD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | BINGHAM FARMS |
| Zip Code Of The Provider | 480254367 |
| 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 | 87 |
| Number Of Services | 5090.7 |
| Number Of Medicare Beneficiaries | 1635 |
| Total Submitted Charge Amount | 1161737.5 |
| Total Medicare Allowed Amount | 737066.98 |
| Total Medicare Payment Amount | 569383.96 |
| Total Medicare Standardized Payment Amount | 560787.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 339 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 22025 |
| Total Drug Medicare AllowedAmount | 17886.76 |
| Total Drug Medicare PaymentAmount | 14023.09 |
| Total Drug Medicare Standardized Payment Amount | 14023.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 4751.7 |
| Number Of Medicare Beneficiaries With Medical Services | 1635 |
| Total Medical Submitted Charge Amount | 1139712.5 |
| Total Medical Medicare Allowed Amount | 719180.22 |
| Total Medical Medicare Payment Amount | 555360.87 |
| Total Medical Medicare Standardized Payment Amount | 546764.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 653 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 266 |
| Number Of Female Beneficiaries | 911 |
| Number Of Male Beneficiaries | 724 |
| Number Of Non Hispanic White Beneficiaries | 1147 |
| Number Of Black or African American Beneficiaries | 421 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1389 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4737 |