| National Provider Identifier [NPI]: | 1306861414 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 44344 DEQUINDRE RD |
| Street Address 2 Of The Provider | SUITE 520 |
| City Of The Provider | STERLING HEIGHTS |
| Zip Code Of The Provider | 483141038 |
| 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 | 43 |
| Number Of Services | 3504 |
| Number Of Medicare Beneficiaries | 1236 |
| Total Submitted Charge Amount | 516261 |
| Total Medicare Allowed Amount | 392446.95 |
| Total Medicare Payment Amount | 300424.49 |
| Total Medicare Standardized Payment Amount | 294551.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 565 |
| Total Drug Medicare AllowedAmount | 290.6 |
| Total Drug Medicare PaymentAmount | 284.76 |
| Total Drug Medicare Standardized Payment Amount | 284.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 3489 |
| Number Of Medicare Beneficiaries With Medical Services | 1236 |
| Total Medical Submitted Charge Amount | 515696 |
| Total Medical Medicare Allowed Amount | 392156.35 |
| Total Medical Medicare Payment Amount | 300139.73 |
| Total Medical Medicare Standardized Payment Amount | 294266.37 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 450 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 684 |
| Number Of Male Beneficiaries | 552 |
| Number Of Non Hispanic White Beneficiaries | 1139 |
| Number Of Black or African American Beneficiaries | 29 |
| 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 | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1029 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 63 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.4468 |