| National Provider Identifier [NPI]: | 1396812335 |
| Last Name Of The Provider | JANISZEWSKI |
| First Name Of The Provider | EVA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24896 CHRISANTA DR |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926914800 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 386 |
| Number Of Medicare Beneficiaries | 75 |
| Total Submitted Charge Amount | 38160 |
| Total Medicare Allowed Amount | 33191.18 |
| Total Medicare Payment Amount | 24032.36 |
| Total Medicare Standardized Payment Amount | 21906.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 750 |
| Total Drug Medicare AllowedAmount | 237.14 |
| Total Drug Medicare PaymentAmount | 214.98 |
| Total Drug Medicare Standardized Payment Amount | 214.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 365 |
| Number Of Medicare Beneficiaries With Medical Services | 75 |
| Total Medical Submitted Charge Amount | 37410 |
| Total Medical Medicare Allowed Amount | 32954.04 |
| Total Medical Medicare Payment Amount | 23817.38 |
| Total Medical Medicare Standardized Payment Amount | 21691.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 52 |
| Number Of Male Beneficiaries | 23 |
| 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 | |
| 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 | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0557 |