| National Provider Identifier [NPI]: | 1649277211 |
| Last Name Of The Provider | KOWALCZYK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3937 PATIENT CARE WAY |
| Street Address 2 Of The Provider | STE 104 |
| City Of The Provider | LANSING |
| Zip Code Of The Provider | 489114287 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 5233 |
| Number Of Medicare Beneficiaries | 1350 |
| Total Submitted Charge Amount | 551111 |
| Total Medicare Allowed Amount | 399861.16 |
| Total Medicare Payment Amount | 307136.14 |
| Total Medicare Standardized Payment Amount | 316413.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 834 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 16177 |
| Total Drug Medicare AllowedAmount | 13319.97 |
| Total Drug Medicare PaymentAmount | 10214.33 |
| Total Drug Medicare Standardized Payment Amount | 10214.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 4399 |
| Number Of Medicare Beneficiaries With Medical Services | 1350 |
| Total Medical Submitted Charge Amount | 534934 |
| Total Medical Medicare Allowed Amount | 386541.19 |
| Total Medical Medicare Payment Amount | 296921.81 |
| Total Medical Medicare Standardized Payment Amount | 306198.71 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 329 |
| Number Of Beneficiaries Age 65 to 74 | 471 |
| Number Of Beneficiaries Age 75 to 84 | 363 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 736 |
| Number Of Male Beneficiaries | 614 |
| Number Of Non Hispanic White Beneficiaries | 1106 |
| Number Of Black or African American Beneficiaries | 175 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 951 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 399 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0254 |