| National Provider Identifier [NPI]: | 1538106059 |
| Last Name Of The Provider | HADDAD |
| First Name Of The Provider | LUAY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | DETROIT RECEIVING HOSPITAL CRISIS CENTER |
| Street Address 2 Of The Provider | 4201 ST ANTOINE |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 48201 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 8919 |
| Number Of Medicare Beneficiaries | 978 |
| Total Submitted Charge Amount | 851258.41 |
| Total Medicare Allowed Amount | 710360.43 |
| Total Medicare Payment Amount | 547984.26 |
| Total Medicare Standardized Payment Amount | 535863.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 149 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 2899.8 |
| Total Drug Medicare AllowedAmount | 2852.12 |
| Total Drug Medicare PaymentAmount | 2236.1 |
| Total Drug Medicare Standardized Payment Amount | 2236.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 8770 |
| Number Of Medicare Beneficiaries With Medical Services | 978 |
| Total Medical Submitted Charge Amount | 848358.61 |
| Total Medical Medicare Allowed Amount | 707508.31 |
| Total Medical Medicare Payment Amount | 545748.16 |
| Total Medical Medicare Standardized Payment Amount | 533627.34 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 654 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 441 |
| Number Of Male Beneficiaries | 537 |
| Number Of Non Hispanic White Beneficiaries | 231 |
| Number Of Black or African American Beneficiaries | 683 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 791 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 67 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 74 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.173 |