| National Provider Identifier [NPI]: | 1962585596 |
| Last Name Of The Provider | SU |
| First Name Of The Provider | WEI |
| 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 | 43900 GARFIELD RD STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLINTON TOWNSHIP |
| Zip Code Of The Provider | 480381137 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 4172 |
| Number Of Medicare Beneficiaries | 2082 |
| Total Submitted Charge Amount | 628480 |
| Total Medicare Allowed Amount | 291878.97 |
| Total Medicare Payment Amount | 226528.4 |
| Total Medicare Standardized Payment Amount | 215477.82 |
| 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 | 5 |
| Number Of Medical Services | 4172 |
| Number Of Medicare Beneficiaries With Medical Services | 2082 |
| Total Medical Submitted Charge Amount | 628480 |
| Total Medical Medicare Allowed Amount | 291878.97 |
| Total Medical Medicare Payment Amount | 226528.4 |
| Total Medical Medicare Standardized Payment Amount | 215477.82 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 919 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 1052 |
| Number Of Male Beneficiaries | 1030 |
| Number Of Non Hispanic White Beneficiaries | 2014 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1996 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1297 |