| National Provider Identifier [NPI]: | 1164499505 |
| Last Name Of The Provider | KUCHARZYK |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11360 BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CROWN POINT |
| Zip Code Of The Provider | 463077104 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 3436 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 2269087.5 |
| Total Medicare Allowed Amount | 294509.32 |
| Total Medicare Payment Amount | 219933.54 |
| Total Medicare Standardized Payment Amount | 229596.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1536 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 33792 |
| Total Drug Medicare AllowedAmount | 19088.21 |
| Total Drug Medicare PaymentAmount | 13336.67 |
| Total Drug Medicare Standardized Payment Amount | 13336.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 1900 |
| Number Of Medicare Beneficiaries With Medical Services | 413 |
| Total Medical Submitted Charge Amount | 2235295.5 |
| Total Medical Medicare Allowed Amount | 275421.11 |
| Total Medical Medicare Payment Amount | 206596.87 |
| Total Medical Medicare Standardized Payment Amount | 216259.82 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 370 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.023 |