| National Provider Identifier [NPI]: | 1821087453 |
| Last Name Of The Provider | DENCKLAU |
| First Name Of The Provider | VERNON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1107 STONE ST |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | PORT HURON |
| Zip Code Of The Provider | 480603569 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Thoracic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 2702 |
| Number Of Medicare Beneficiaries | 1116 |
| Total Submitted Charge Amount | 806780.5 |
| Total Medicare Allowed Amount | 397571.74 |
| Total Medicare Payment Amount | 297832.62 |
| Total Medicare Standardized Payment Amount | 310584.62 |
| 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 | 116 |
| Number Of Medical Services | 2702 |
| Number Of Medicare Beneficiaries With Medical Services | 1116 |
| Total Medical Submitted Charge Amount | 806780.5 |
| Total Medical Medicare Allowed Amount | 397571.74 |
| Total Medical Medicare Payment Amount | 297832.62 |
| Total Medical Medicare Standardized Payment Amount | 310584.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 169 |
| Number Of Beneficiaries Age 65 to 74 | 427 |
| Number Of Beneficiaries Age 75 to 84 | 357 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 598 |
| Number Of Non Hispanic White Beneficiaries | 1063 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 873 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 243 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8648 |