National Provider Identifier [NPI]: |
1851301352 |
Last Name Of The Provider |
KOWYNIA |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
43211 DALCOMA |
Street Address 2 Of The Provider |
STE 7 |
City Of The Provider |
CLINTON TWP |
Zip Code Of The Provider |
48038 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
1020 |
Number Of Medicare Beneficiaries |
344 |
Total Submitted Charge Amount |
223693.5 |
Total Medicare Allowed Amount |
121299.01 |
Total Medicare Payment Amount |
93936.44 |
Total Medicare Standardized Payment Amount |
89524.99 |
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 |
75 |
Number Of Medical Services |
1020 |
Number Of Medicare Beneficiaries With Medical Services |
344 |
Total Medical Submitted Charge Amount |
223693.5 |
Total Medical Medicare Allowed Amount |
121299.01 |
Total Medical Medicare Payment Amount |
93936.44 |
Total Medical Medicare Standardized Payment Amount |
89524.99 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
248 |
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.2402 |