| National Provider Identifier [NPI]: | 1073717682 |
| Last Name Of The Provider | KANIOWSKI |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16001 W 9 MILE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480754818 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 7368 |
| Number Of Medicare Beneficiaries | 4544 |
| Total Submitted Charge Amount | 495217 |
| Total Medicare Allowed Amount | 189436.41 |
| Total Medicare Payment Amount | 153557.51 |
| Total Medicare Standardized Payment Amount | 150206.59 |
| 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 | 148 |
| Number Of Medical Services | 7368 |
| Number Of Medicare Beneficiaries With Medical Services | 4544 |
| Total Medical Submitted Charge Amount | 495217 |
| Total Medical Medicare Allowed Amount | 189436.41 |
| Total Medical Medicare Payment Amount | 153557.51 |
| Total Medical Medicare Standardized Payment Amount | 150206.59 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1126 |
| Number Of Beneficiaries Age 65 to 74 | 1534 |
| Number Of Beneficiaries Age 75 to 84 | 1136 |
| Number Of Beneficiaries Age Greater 84 | 748 |
| Number Of Female Beneficiaries | 3175 |
| Number Of Male Beneficiaries | 1369 |
| Number Of Non Hispanic White Beneficiaries | 3491 |
| Number Of Black or African American Beneficiaries | 765 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 159 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3031 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1513 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0232 |