| National Provider Identifier [NPI]: | 1770548646 |
| Last Name Of The Provider | SKOWRON |
| First Name Of The Provider | MAREK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 COFFEE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953554201 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 2841 |
| Number Of Medicare Beneficiaries | 837 |
| Total Submitted Charge Amount | 589610 |
| Total Medicare Allowed Amount | 234703.91 |
| Total Medicare Payment Amount | 158478.74 |
| Total Medicare Standardized Payment Amount | 153211.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 450 |
| Number Of Medicare Beneficiaries With Drug Services | 292 |
| Total Drug Submitted ChargeAmount | 15298 |
| Total Drug Medicare AllowedAmount | 8869.86 |
| Total Drug Medicare PaymentAmount | 8577.65 |
| Total Drug Medicare Standardized Payment Amount | 8577.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 2391 |
| Number Of Medicare Beneficiaries With Medical Services | 799 |
| Total Medical Submitted Charge Amount | 574312 |
| Total Medical Medicare Allowed Amount | 225834.05 |
| Total Medical Medicare Payment Amount | 149901.09 |
| Total Medical Medicare Standardized Payment Amount | 144633.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 359 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 438 |
| Number Of Male Beneficiaries | 399 |
| Number Of Non Hispanic White Beneficiaries | 723 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 667 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0679 |