| National Provider Identifier [NPI]: | 1609832682 |
| Last Name Of The Provider | KAKISH |
| First Name Of The Provider | MELINDA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 23800 ORCHARD LK RD |
| Street Address 2 Of The Provider | STE 210 |
| City Of The Provider | FARMINGTON HILLS |
| Zip Code Of The Provider | 48336 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 403 |
| Number Of Medicare Beneficiaries | 114 |
| Total Submitted Charge Amount | 30972 |
| Total Medicare Allowed Amount | 24422.44 |
| Total Medicare Payment Amount | 18560.86 |
| Total Medicare Standardized Payment Amount | 18247.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1370 |
| Total Drug Medicare AllowedAmount | 1307.45 |
| Total Drug Medicare PaymentAmount | 1281.22 |
| Total Drug Medicare Standardized Payment Amount | 1281.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 370 |
| Number Of Medicare Beneficiaries With Medical Services | 114 |
| Total Medical Submitted Charge Amount | 29602 |
| Total Medical Medicare Allowed Amount | 23114.99 |
| Total Medical Medicare Payment Amount | 17279.64 |
| Total Medical Medicare Standardized Payment Amount | 16966.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 100 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9173 |