| National Provider Identifier [NPI]: | 1043391287 |
| Last Name Of The Provider | HELVIE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | B2 FLOOR CANCER & GERIATRICS CTR RM B2205 |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095904 |
| 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 | 20 |
| Number Of Services | 1039 |
| Number Of Medicare Beneficiaries | 454 |
| Total Submitted Charge Amount | 75487 |
| Total Medicare Allowed Amount | 24699.61 |
| Total Medicare Payment Amount | 20265.85 |
| Total Medicare Standardized Payment Amount | 19571.74 |
| 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 | 20 |
| Number Of Medical Services | 1039 |
| Number Of Medicare Beneficiaries With Medical Services | 454 |
| Total Medical Submitted Charge Amount | 75487 |
| Total Medical Medicare Allowed Amount | 24699.61 |
| Total Medical Medicare Payment Amount | 20265.85 |
| Total Medical Medicare Standardized Payment Amount | 19571.74 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 272 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 368 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| 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 | 386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8979 |