| National Provider Identifier [NPI]: | 1588724454 |
| Last Name Of The Provider | HOLLOWAY |
| First Name Of The Provider | FRANK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | HENRY FORD HEALTH SYSTEM |
| Street Address 2 Of The Provider | 14500 HALL ROAD |
| City Of The Provider | STERLING HEIGHTS |
| Zip Code Of The Provider | 48313 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 760 |
| Number Of Medicare Beneficiaries | 452 |
| Total Submitted Charge Amount | 183681 |
| Total Medicare Allowed Amount | 73804.37 |
| Total Medicare Payment Amount | 53204.71 |
| Total Medicare Standardized Payment Amount | 51677.86 |
| 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 | 42 |
| Number Of Medical Services | 760 |
| Number Of Medicare Beneficiaries With Medical Services | 452 |
| Total Medical Submitted Charge Amount | 183681 |
| Total Medical Medicare Allowed Amount | 73804.37 |
| Total Medical Medicare Payment Amount | 53204.71 |
| Total Medical Medicare Standardized Payment Amount | 51677.86 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 212 |
| Number Of Black or African American Beneficiaries | 209 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5586 |