| National Provider Identifier [NPI]: | 1760437883 |
| Last Name Of The Provider | KWIAT |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 N MCMULLEN BOOTH RD |
| Street Address 2 Of The Provider | SUITE A1 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337595504 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 1122 |
| Number Of Medicare Beneficiaries | 558 |
| Total Submitted Charge Amount | 155847.46 |
| Total Medicare Allowed Amount | 88307.26 |
| Total Medicare Payment Amount | 59476.85 |
| Total Medicare Standardized Payment Amount | 59921.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 1687 |
| Total Drug Medicare AllowedAmount | 541.36 |
| Total Drug Medicare PaymentAmount | 408.13 |
| Total Drug Medicare Standardized Payment Amount | 408.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 1044 |
| Number Of Medicare Beneficiaries With Medical Services | 558 |
| Total Medical Submitted Charge Amount | 154160.46 |
| Total Medical Medicare Allowed Amount | 87765.9 |
| Total Medical Medicare Payment Amount | 59068.72 |
| Total Medical Medicare Standardized Payment Amount | 59513.01 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 282 |
| Number Of Beneficiaries Age 75 to 84 | 144 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 336 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 516 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 526 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9987 |