| National Provider Identifier [NPI]: | 1356450290 |
| Last Name Of The Provider | NOVAK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4070 LAKE DR SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495468294 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 1772 |
| Number Of Medicare Beneficiaries | 401 |
| Total Submitted Charge Amount | 306367.35 |
| Total Medicare Allowed Amount | 132783.94 |
| Total Medicare Payment Amount | 96601.48 |
| Total Medicare Standardized Payment Amount | 103888.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 555 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 27150 |
| Total Drug Medicare AllowedAmount | 9776.48 |
| Total Drug Medicare PaymentAmount | 7658.32 |
| Total Drug Medicare Standardized Payment Amount | 7658.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 1217 |
| Number Of Medicare Beneficiaries With Medical Services | 401 |
| Total Medical Submitted Charge Amount | 279217.35 |
| Total Medical Medicare Allowed Amount | 123007.46 |
| Total Medical Medicare Payment Amount | 88943.16 |
| Total Medical Medicare Standardized Payment Amount | 96230.29 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 115 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 315 |
| Number Of Non Hispanic White Beneficiaries | 349 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 320 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8677 |