| National Provider Identifier [NPI]: | 1801975420 |
| Last Name Of The Provider | BAILEY |
| First Name Of The Provider | CHARLENE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.A. C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15501 METROPOLITAN PKWY |
| Street Address 2 Of The Provider | STE110 |
| City Of The Provider | CLINTON TWP |
| Zip Code Of The Provider | 480361684 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1005 |
| Number Of Medicare Beneficiaries | 137 |
| Total Submitted Charge Amount | 49414.88 |
| Total Medicare Allowed Amount | 31413.18 |
| Total Medicare Payment Amount | 22263.7 |
| Total Medicare Standardized Payment Amount | 26277.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 169 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1219.51 |
| Total Drug Medicare AllowedAmount | 876.44 |
| Total Drug Medicare PaymentAmount | 850.68 |
| Total Drug Medicare Standardized Payment Amount | 850.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 836 |
| Number Of Medicare Beneficiaries With Medical Services | 137 |
| Total Medical Submitted Charge Amount | 48195.37 |
| Total Medical Medicare Allowed Amount | 30536.74 |
| Total Medical Medicare Payment Amount | 21413.02 |
| Total Medical Medicare Standardized Payment Amount | 25427.19 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 91 |
| Number Of Male Beneficiaries | 46 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1898 |