| National Provider Identifier [NPI]: | 1720281132 |
| Last Name Of The Provider | PLAKSEYCHUK |
| First Name Of The Provider | ANTON |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3471 5TH AVE |
| Street Address 2 Of The Provider | SUITE 1010 |
| City Of The Provider | PITTSBURGH |
| Zip Code Of The Provider | 152133215 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 427 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 297089.5 |
| Total Medicare Allowed Amount | 86164.14 |
| Total Medicare Payment Amount | 63106.73 |
| Total Medicare Standardized Payment Amount | 69169.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1174 |
| Total Drug Medicare AllowedAmount | 449.67 |
| Total Drug Medicare PaymentAmount | 339.68 |
| Total Drug Medicare Standardized Payment Amount | 339.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 335 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 295915.5 |
| Total Medical Medicare Allowed Amount | 85714.47 |
| Total Medical Medicare Payment Amount | 62767.05 |
| Total Medical Medicare Standardized Payment Amount | 68829.85 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| 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 | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3948 |