| National Provider Identifier [NPI]: | 1891803029 |
| Last Name Of The Provider | YADMARK |
| First Name Of The Provider | CHUCK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19335 MERRIMAN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIVONIA |
| Zip Code Of The Provider | 48152 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 430 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 22807 |
| Total Medicare Allowed Amount | 17462.15 |
| Total Medicare Payment Amount | 12171.69 |
| Total Medicare Standardized Payment Amount | 12145.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 975 |
| Total Drug Medicare AllowedAmount | 577.32 |
| Total Drug Medicare PaymentAmount | 391.99 |
| Total Drug Medicare Standardized Payment Amount | 391.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 349 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 21832 |
| Total Medical Medicare Allowed Amount | 16884.83 |
| Total Medical Medicare Payment Amount | 11779.7 |
| Total Medical Medicare Standardized Payment Amount | 11753.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0175 |