| National Provider Identifier [NPI]: | 1902097512 |
| Last Name Of The Provider | TOMCZYK |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12 KIRBY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNTAIN TOP |
| Zip Code Of The Provider | 187071215 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 3376 |
| Number Of Medicare Beneficiaries | 698 |
| Total Submitted Charge Amount | 415224 |
| Total Medicare Allowed Amount | 192147.33 |
| Total Medicare Payment Amount | 138861.37 |
| Total Medicare Standardized Payment Amount | 144304.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 340 |
| Number Of Medicare Beneficiaries With Drug Services | 222 |
| Total Drug Submitted ChargeAmount | 12144 |
| Total Drug Medicare AllowedAmount | 6618.1 |
| Total Drug Medicare PaymentAmount | 6380.85 |
| Total Drug Medicare Standardized Payment Amount | 6380.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 3036 |
| Number Of Medicare Beneficiaries With Medical Services | 698 |
| Total Medical Submitted Charge Amount | 403080 |
| Total Medical Medicare Allowed Amount | 185529.23 |
| Total Medical Medicare Payment Amount | 132480.52 |
| Total Medical Medicare Standardized Payment Amount | 137924 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 263 |
| Number Of Beneficiaries Age 75 to 84 | 190 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 374 |
| Number Of Male Beneficiaries | 324 |
| Number Of Non Hispanic White Beneficiaries | 663 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 532 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3681 |