| National Provider Identifier [NPI]: | 1750366605 |
| Last Name Of The Provider | POTTS |
| First Name Of The Provider | KEVIN |
| 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 | 30117 SCHOENHERR RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 480886851 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 5142 |
| Number Of Medicare Beneficiaries | 444 |
| Total Submitted Charge Amount | 567728 |
| Total Medicare Allowed Amount | 461964.81 |
| Total Medicare Payment Amount | 357714.6 |
| Total Medicare Standardized Payment Amount | 346939.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 172 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 2048 |
| Total Drug Medicare AllowedAmount | 1385.7 |
| Total Drug Medicare PaymentAmount | 1178.61 |
| Total Drug Medicare Standardized Payment Amount | 1178.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 4970 |
| Number Of Medicare Beneficiaries With Medical Services | 444 |
| Total Medical Submitted Charge Amount | 565680 |
| Total Medical Medicare Allowed Amount | 460579.11 |
| Total Medical Medicare Payment Amount | 356535.99 |
| Total Medical Medicare Standardized Payment Amount | 345760.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 186 |
| Number Of Non Hispanic White Beneficiaries | 238 |
| Number Of Black or African American Beneficiaries | 193 |
| 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 | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 27 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 75 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 3.7755 |