| National Provider Identifier [NPI]: | 1780774083 |
| Last Name Of The Provider | CZARNECKI |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 MCCALLIE AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374042934 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 5988 |
| Number Of Medicare Beneficiaries | 848 |
| Total Submitted Charge Amount | 1692808 |
| Total Medicare Allowed Amount | 590196.66 |
| Total Medicare Payment Amount | 454067.35 |
| Total Medicare Standardized Payment Amount | 482194.71 |
| 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 | 50 |
| Number Of Medical Services | 5988 |
| Number Of Medicare Beneficiaries With Medical Services | 848 |
| Total Medical Submitted Charge Amount | 1692808 |
| Total Medical Medicare Allowed Amount | 590196.66 |
| Total Medical Medicare Payment Amount | 454067.35 |
| Total Medical Medicare Standardized Payment Amount | 482194.71 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 334 |
| Number Of Beneficiaries Age 75 to 84 | 228 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 480 |
| Number Of Male Beneficiaries | 368 |
| Number Of Non Hispanic White Beneficiaries | 764 |
| Number Of Black or African American Beneficiaries | |
| 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 | 539 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 309 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0944 |