| National Provider Identifier [NPI]: | 1548383276 |
| Last Name Of The Provider | STEIN |
| First Name Of The Provider | TRICIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2799 WEST GRAND BLVD. |
| Street Address 2 Of The Provider | HENRY FORD HOSPITAL |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 48202 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 921 |
| Number Of Medicare Beneficiaries | 388 |
| Total Submitted Charge Amount | 266379 |
| Total Medicare Allowed Amount | 96170.64 |
| Total Medicare Payment Amount | 74742.42 |
| Total Medicare Standardized Payment Amount | 72644.45 |
| 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 | 14 |
| Number Of Medical Services | 921 |
| Number Of Medicare Beneficiaries With Medical Services | 388 |
| Total Medical Submitted Charge Amount | 266379 |
| Total Medical Medicare Allowed Amount | 96170.64 |
| Total Medical Medicare Payment Amount | 74742.42 |
| Total Medical Medicare Standardized Payment Amount | 72644.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 225 |
| Number Of Black or African American Beneficiaries | 137 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 71 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 3.1232 |