| National Provider Identifier [NPI]: | 1588612923 |
| Last Name Of The Provider | JANKOWSKI |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18181 OAKWOOD BLVD |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | DEARBORN |
| Zip Code Of The Provider | 481245032 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 15329 |
| Number Of Medicare Beneficiaries | 673 |
| Total Submitted Charge Amount | 2756503.64 |
| Total Medicare Allowed Amount | 631553.14 |
| Total Medicare Payment Amount | 483870.32 |
| Total Medicare Standardized Payment Amount | 471593.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 6392 |
| Number Of Medicare Beneficiaries With Drug Services | 413 |
| Total Drug Submitted ChargeAmount | 155699 |
| Total Drug Medicare AllowedAmount | 16181.3 |
| Total Drug Medicare PaymentAmount | 12842.15 |
| Total Drug Medicare Standardized Payment Amount | 12842.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 8937 |
| Number Of Medicare Beneficiaries With Medical Services | 673 |
| Total Medical Submitted Charge Amount | 2600804.64 |
| Total Medical Medicare Allowed Amount | 615371.84 |
| Total Medical Medicare Payment Amount | 471028.17 |
| Total Medical Medicare Standardized Payment Amount | 458751.08 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 436 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 311 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 113 |
| Number Of Black or African American Beneficiaries | 538 |
| 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 | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 478 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 34 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.658 |