| National Provider Identifier [NPI]: | 1366659260 |
| Last Name Of The Provider | SHAKIR |
| First Name Of The Provider | TEHMINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2751 E JEFFERSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482074180 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 8797 |
| Number Of Medicare Beneficiaries | 100 |
| Total Submitted Charge Amount | 234701.65 |
| Total Medicare Allowed Amount | 135902.79 |
| Total Medicare Payment Amount | 102783.16 |
| Total Medicare Standardized Payment Amount | 101975.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7712 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 58124.25 |
| Total Drug Medicare AllowedAmount | 54883.41 |
| Total Drug Medicare PaymentAmount | 42531.54 |
| Total Drug Medicare Standardized Payment Amount | 42531.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 1085 |
| Number Of Medicare Beneficiaries With Medical Services | 100 |
| Total Medical Submitted Charge Amount | 176577.4 |
| Total Medical Medicare Allowed Amount | 81019.38 |
| Total Medical Medicare Payment Amount | 60251.62 |
| Total Medical Medicare Standardized Payment Amount | 59443.69 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 11 |
| Number Of Beneficiaries Age 75 to 84 | 0 |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 37 |
| Number Of Black or African American Beneficiaries | 45 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 60 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 60 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6017 |