| National Provider Identifier [NPI]: | 1881683373 |
| Last Name Of The Provider | SEIDMAN |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28595 ORCHARD LAKE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | FARMINGTON HILLS |
| Zip Code Of The Provider | 483342977 |
| 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 | 67 |
| Number Of Services | 14694 |
| Number Of Medicare Beneficiaries | 1344 |
| Total Submitted Charge Amount | 2369411 |
| Total Medicare Allowed Amount | 660912.95 |
| Total Medicare Payment Amount | 480431.92 |
| Total Medicare Standardized Payment Amount | 513640.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 11317 |
| Number Of Medicare Beneficiaries With Drug Services | 380 |
| Total Drug Submitted ChargeAmount | 73571 |
| Total Drug Medicare AllowedAmount | 13652.78 |
| Total Drug Medicare PaymentAmount | 9652.29 |
| Total Drug Medicare Standardized Payment Amount | 9652.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3377 |
| Number Of Medicare Beneficiaries With Medical Services | 1344 |
| Total Medical Submitted Charge Amount | 2295840 |
| Total Medical Medicare Allowed Amount | 647260.17 |
| Total Medical Medicare Payment Amount | 470779.63 |
| Total Medical Medicare Standardized Payment Amount | 503988.68 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 462 |
| Number Of Beneficiaries Age 65 to 74 | 464 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 865 |
| Number Of Male Beneficiaries | 479 |
| Number Of Non Hispanic White Beneficiaries | 1117 |
| Number Of Black or African American Beneficiaries | 169 |
| 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 | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1062 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 282 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.2403 |