National Provider Identifier [NPI]: |
1174582134 |
Last Name Of The Provider |
ZIEMKOWSKI |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 OAKLAND DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
KALAMAZOO |
Zip Code Of The Provider |
490081282 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
33654 |
Total Medicare Allowed Amount |
20215.94 |
Total Medicare Payment Amount |
14316.17 |
Total Medicare Standardized Payment Amount |
14882 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
926 |
Total Drug Medicare AllowedAmount |
646.25 |
Total Drug Medicare PaymentAmount |
621.18 |
Total Drug Medicare Standardized Payment Amount |
621.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
411 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
32728 |
Total Medical Medicare Allowed Amount |
19569.69 |
Total Medical Medicare Payment Amount |
13694.99 |
Total Medical Medicare Standardized Payment Amount |
14260.82 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
94 |
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 |
33 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6158 |