| National Provider Identifier [NPI]: | 1083954770 |
| Last Name Of The Provider | JABLONOWSKI |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4967 CROOKS RD |
| Street Address 2 Of The Provider | STE. 130 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 480985801 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 3046 |
| Number Of Medicare Beneficiaries | 315 |
| Total Submitted Charge Amount | 478978 |
| Total Medicare Allowed Amount | 196950.32 |
| Total Medicare Payment Amount | 151401.44 |
| Total Medicare Standardized Payment Amount | 173058.97 |
| 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 | 6 |
| Number Of Medical Services | 3046 |
| Number Of Medicare Beneficiaries With Medical Services | 315 |
| Total Medical Submitted Charge Amount | 478978 |
| Total Medical Medicare Allowed Amount | 196950.32 |
| Total Medical Medicare Payment Amount | 151401.44 |
| Total Medical Medicare Standardized Payment Amount | 173058.97 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 202 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 291 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 53 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 2.9865 |