| National Provider Identifier [NPI]: | 1457485237 |
| Last Name Of The Provider | HOWARD |
| First Name Of The Provider | THELMA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4000 TOWN CENTER |
| Street Address 2 Of The Provider | SUITE 370 |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 48075 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 717 |
| Number Of Medicare Beneficiaries | 105 |
| Total Submitted Charge Amount | 46514 |
| Total Medicare Allowed Amount | 29816.04 |
| Total Medicare Payment Amount | 23071.07 |
| Total Medicare Standardized Payment Amount | 26850.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 290 |
| Total Drug Medicare AllowedAmount | 248.82 |
| Total Drug Medicare PaymentAmount | 243.89 |
| Total Drug Medicare Standardized Payment Amount | 243.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 688 |
| Number Of Medicare Beneficiaries With Medical Services | 105 |
| Total Medical Submitted Charge Amount | 46224 |
| Total Medical Medicare Allowed Amount | 29567.22 |
| Total Medical Medicare Payment Amount | 22827.18 |
| Total Medical Medicare Standardized Payment Amount | 26606.72 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 25 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 57 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4545 |