| National Provider Identifier [NPI]: | 1083807077 |
| Last Name Of The Provider | UNDERWOOD |
| First Name Of The Provider | SHEREEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3475 BELLE CHASE WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LANSING |
| Zip Code Of The Provider | 48911 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 14720 |
| Number Of Medicare Beneficiaries | 75 |
| Total Submitted Charge Amount | 196260.78 |
| Total Medicare Allowed Amount | 147003.4 |
| Total Medicare Payment Amount | 110378.98 |
| Total Medicare Standardized Payment Amount | 112619.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 14233 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 127092.01 |
| Total Drug Medicare AllowedAmount | 114205.78 |
| Total Drug Medicare PaymentAmount | 87889.09 |
| Total Drug Medicare Standardized Payment Amount | 87889.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 487 |
| Number Of Medicare Beneficiaries With Medical Services | 75 |
| Total Medical Submitted Charge Amount | 69168.77 |
| Total Medical Medicare Allowed Amount | 32797.62 |
| Total Medical Medicare Payment Amount | 22489.89 |
| Total Medical Medicare Standardized Payment Amount | 24729.92 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 33 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 59 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 16 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 59 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0107 |