| National Provider Identifier [NPI]: | 1033144266 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 LAFAYETTE AVE SE |
| Street Address 2 Of The Provider | STE 415 |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495034693 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1790 |
| Number Of Medicare Beneficiaries | 525 |
| Total Submitted Charge Amount | 244075 |
| Total Medicare Allowed Amount | 128239.87 |
| Total Medicare Payment Amount | 96961.27 |
| Total Medicare Standardized Payment Amount | 101090.48 |
| 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 | 29 |
| Number Of Medical Services | 1790 |
| Number Of Medicare Beneficiaries With Medical Services | 525 |
| Total Medical Submitted Charge Amount | 244075 |
| Total Medical Medicare Allowed Amount | 128239.87 |
| Total Medical Medicare Payment Amount | 96961.27 |
| Total Medical Medicare Standardized Payment Amount | 101090.48 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 267 |
| Number Of Male Beneficiaries | 258 |
| Number Of Non Hispanic White Beneficiaries | 427 |
| Number Of Black or African American Beneficiaries | 74 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 63 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.1956 |