| National Provider Identifier [NPI]: | 1063628154 |
| Last Name Of The Provider | MAUCH |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4201 SAINT ANTOINE ST |
| Street Address 2 Of The Provider | DRH 3L-8, DEPT OF RADIOLOGY |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482012153 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 215 |
| Number Of Services | 7923 |
| Number Of Medicare Beneficiaries | 4415 |
| Total Submitted Charge Amount | 808330 |
| Total Medicare Allowed Amount | 230167.01 |
| Total Medicare Payment Amount | 176231.15 |
| Total Medicare Standardized Payment Amount | 182396.22 |
| 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 | 215 |
| Number Of Medical Services | 7923 |
| Number Of Medicare Beneficiaries With Medical Services | 4415 |
| Total Medical Submitted Charge Amount | 808330 |
| Total Medical Medicare Allowed Amount | 230167.01 |
| Total Medical Medicare Payment Amount | 176231.15 |
| Total Medical Medicare Standardized Payment Amount | 182396.22 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 991 |
| Number Of Beneficiaries Age 65 to 74 | 1597 |
| Number Of Beneficiaries Age 75 to 84 | 1171 |
| Number Of Beneficiaries Age Greater 84 | 656 |
| Number Of Female Beneficiaries | 2840 |
| Number Of Male Beneficiaries | 1575 |
| Number Of Non Hispanic White Beneficiaries | 4164 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1246 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5817 |