| National Provider Identifier [NPI]: | 1972540466 |
| Last Name Of The Provider | STETTNER |
| First Name Of The Provider | SHELLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 WALTER P CHRYSLER SERVICE DR |
| Street Address 2 Of The Provider | TOLAN PARK |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482012167 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neuropsychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 652 |
| Number Of Medicare Beneficiaries | 502 |
| Total Submitted Charge Amount | 138705 |
| Total Medicare Allowed Amount | 69632.09 |
| Total Medicare Payment Amount | 50896.56 |
| Total Medicare Standardized Payment Amount | 49419.44 |
| 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 | 18 |
| Number Of Medical Services | 652 |
| Number Of Medicare Beneficiaries With Medical Services | 502 |
| Total Medical Submitted Charge Amount | 138705 |
| Total Medical Medicare Allowed Amount | 69632.09 |
| Total Medical Medicare Payment Amount | 50896.56 |
| Total Medical Medicare Standardized Payment Amount | 49419.44 |
| Average Age Of Beneficiaries | 54 |
| Number Of Beneficiaries Age Less65 | 351 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 206 |
| Number Of Male Beneficiaries | 296 |
| Number Of Non Hispanic White Beneficiaries | 84 |
| Number Of Black or African American Beneficiaries | 398 |
| 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 | 109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 30 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 67 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 74 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.222 |