| National Provider Identifier [NPI]: | 1457321184 |
| Last Name Of The Provider | KODRIK |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28595 ORCHARD LAKE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | FARMINGTON HILLS |
| Zip Code Of The Provider | 483342977 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 3723 |
| Number Of Medicare Beneficiaries | 673 |
| Total Submitted Charge Amount | 276545 |
| Total Medicare Allowed Amount | 185409.02 |
| Total Medicare Payment Amount | 136632.58 |
| Total Medicare Standardized Payment Amount | 134169.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2464 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 16990 |
| Total Drug Medicare AllowedAmount | 13536.61 |
| Total Drug Medicare PaymentAmount | 9268.02 |
| Total Drug Medicare Standardized Payment Amount | 9268.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1259 |
| Number Of Medicare Beneficiaries With Medical Services | 673 |
| Total Medical Submitted Charge Amount | 259555 |
| Total Medical Medicare Allowed Amount | 171872.41 |
| Total Medical Medicare Payment Amount | 127364.56 |
| Total Medical Medicare Standardized Payment Amount | 124901.52 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 508 |
| Number Of Black or African American Beneficiaries | 122 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 439 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 234 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 33 |
| Average HCC Risk Score Of Beneficiaries | 2.1922 |