| National Provider Identifier [NPI]: | 1609189240 |
| Last Name Of The Provider | JANICKI |
| First Name Of The Provider | MARCUS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3030 NORTH ROCKY POINT DRIVE WEST |
| Street Address 2 Of The Provider | SUITE 670 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336075906 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 2037 |
| Number Of Medicare Beneficiaries | 532 |
| Total Submitted Charge Amount | 425799 |
| Total Medicare Allowed Amount | 253199.09 |
| Total Medicare Payment Amount | 198022.28 |
| Total Medicare Standardized Payment Amount | 198289.89 |
| 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 | 22 |
| Number Of Medical Services | 2037 |
| Number Of Medicare Beneficiaries With Medical Services | 532 |
| Total Medical Submitted Charge Amount | 425799 |
| Total Medical Medicare Allowed Amount | 253199.09 |
| Total Medical Medicare Payment Amount | 198022.28 |
| Total Medical Medicare Standardized Payment Amount | 198289.89 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 330 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1751 |