| National Provider Identifier [NPI]: | 1053386367 |
| Last Name Of The Provider | EVENHOUSE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1150 N HUDSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOWELL |
| Zip Code Of The Provider | 493311000 |
| 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 | 73 |
| Number Of Services | 2145 |
| Number Of Medicare Beneficiaries | 384 |
| Total Submitted Charge Amount | 200769 |
| Total Medicare Allowed Amount | 107726.67 |
| Total Medicare Payment Amount | 79397.11 |
| Total Medicare Standardized Payment Amount | 82885.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 152 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 7113 |
| Total Drug Medicare AllowedAmount | 4415.61 |
| Total Drug Medicare PaymentAmount | 4051.72 |
| Total Drug Medicare Standardized Payment Amount | 4051.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 1993 |
| Number Of Medicare Beneficiaries With Medical Services | 384 |
| Total Medical Submitted Charge Amount | 193656 |
| Total Medical Medicare Allowed Amount | 103311.06 |
| Total Medical Medicare Payment Amount | 75345.39 |
| Total Medical Medicare Standardized Payment Amount | 78833.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 194 |
| Number Of Male Beneficiaries | 190 |
| Number Of Non Hispanic White Beneficiaries | 362 |
| 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 | 298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6359 |