| National Provider Identifier [NPI]: | 1215994538 |
| Last Name Of The Provider | KWASNIK |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | SOUTH SHORE HOSPITAL |
| Street Address 2 Of The Provider | BRIGHAM AND WOMENS SURGICAL ASSOCIATES |
| City Of The Provider | SOUTH WEYMOUTH |
| Zip Code Of The Provider | 02190 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 697.4 |
| Number Of Medicare Beneficiaries | 361 |
| Total Submitted Charge Amount | 461432 |
| Total Medicare Allowed Amount | 124328.43 |
| Total Medicare Payment Amount | 95861.13 |
| Total Medicare Standardized Payment Amount | 92878.37 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | 336 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1146 |