| National Provider Identifier [NPI]: | 1811992613 |
| Last Name Of The Provider | DEBIEC |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5594 STATE ROUTE 7 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANDOVER |
| Zip Code Of The Provider | 440039490 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 2758 |
| Number Of Medicare Beneficiaries | 2206 |
| Total Submitted Charge Amount | 179155 |
| Total Medicare Allowed Amount | 128362.42 |
| Total Medicare Payment Amount | 93371.97 |
| Total Medicare Standardized Payment Amount | 98516.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 2758 |
| Number Of Medicare Beneficiaries With Medical Services | 2206 |
| Total Medical Submitted Charge Amount | 179155 |
| Total Medical Medicare Allowed Amount | 128362.42 |
| Total Medical Medicare Payment Amount | 93371.97 |
| Total Medical Medicare Standardized Payment Amount | 98516.76 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 481 |
| Number Of Beneficiaries Age 65 to 74 | 321 |
| Number Of Beneficiaries Age 75 to 84 | 479 |
| Number Of Beneficiaries Age Greater 84 | 925 |
| Number Of Female Beneficiaries | 1429 |
| Number Of Male Beneficiaries | 777 |
| Number Of Non Hispanic White Beneficiaries | 2002 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 240 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1966 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 68 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 31 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9112 |