| National Provider Identifier [NPI]: | 1225054943 |
| Last Name Of The Provider | KORNELI |
| First Name Of The Provider | FERDINAND |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 E MICHIGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAYLING |
| Zip Code Of The Provider | 497387074 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 3828 |
| Number Of Medicare Beneficiaries | 2118 |
| Total Submitted Charge Amount | 89698 |
| Total Medicare Allowed Amount | 48022.19 |
| Total Medicare Payment Amount | 35172.98 |
| Total Medicare Standardized Payment Amount | 34659.49 |
| 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 | 12 |
| Number Of Medical Services | 3828 |
| Number Of Medicare Beneficiaries With Medical Services | 2118 |
| Total Medical Submitted Charge Amount | 89698 |
| Total Medical Medicare Allowed Amount | 48022.19 |
| Total Medical Medicare Payment Amount | 35172.98 |
| Total Medical Medicare Standardized Payment Amount | 34659.49 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 752 |
| Number Of Beneficiaries Age 75 to 84 | 655 |
| Number Of Beneficiaries Age Greater 84 | 267 |
| Number Of Female Beneficiaries | 1082 |
| Number Of Male Beneficiaries | 1036 |
| Number Of Non Hispanic White Beneficiaries | 2062 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1526 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 592 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4405 |