| National Provider Identifier [NPI]: | 1285797506 |
| Last Name Of The Provider | KOZAK |
| First Name Of The Provider | ANGELA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2955 CENTRAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROWNSVILLE |
| Zip Code Of The Provider | 785208958 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 4306 |
| Number Of Medicare Beneficiaries | 423 |
| Total Submitted Charge Amount | 1115155 |
| Total Medicare Allowed Amount | 441329.48 |
| Total Medicare Payment Amount | 337739.8 |
| Total Medicare Standardized Payment Amount | 356336.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 646 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 56525 |
| Total Drug Medicare AllowedAmount | 25265.08 |
| Total Drug Medicare PaymentAmount | 19323.61 |
| Total Drug Medicare Standardized Payment Amount | 19323.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3660 |
| Number Of Medicare Beneficiaries With Medical Services | 423 |
| Total Medical Submitted Charge Amount | 1058630 |
| Total Medical Medicare Allowed Amount | 416064.4 |
| Total Medical Medicare Payment Amount | 318416.19 |
| Total Medical Medicare Standardized Payment Amount | 337012.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 312 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 220 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 65 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.2802 |