National Provider Identifier [NPI]: |
1003807306 |
Last Name Of The Provider |
ZAWACKI |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
825 DELBON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TURLOCK |
Zip Code Of The Provider |
953822016 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
1207 |
Number Of Medicare Beneficiaries |
563 |
Total Submitted Charge Amount |
475707 |
Total Medicare Allowed Amount |
111133.52 |
Total Medicare Payment Amount |
86199.95 |
Total Medicare Standardized Payment Amount |
85081.53 |
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 |
43 |
Number Of Medical Services |
1207 |
Number Of Medicare Beneficiaries With Medical Services |
563 |
Total Medical Submitted Charge Amount |
475707 |
Total Medical Medicare Allowed Amount |
111133.52 |
Total Medical Medicare Payment Amount |
86199.95 |
Total Medical Medicare Standardized Payment Amount |
85081.53 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
174 |
Number Of Beneficiaries Age 75 to 84 |
156 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
338 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
172 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
328 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9727 |