| National Provider Identifier [NPI]: | 1790704914 |
| Last Name Of The Provider | BUCZYNSKI |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 311 N 4TH ST |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 215501395 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1830 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 208304.31 |
| Total Medicare Allowed Amount | 158840.17 |
| Total Medicare Payment Amount | 111808.36 |
| Total Medicare Standardized Payment Amount | 111273.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 3913.3 |
| Total Drug Medicare AllowedAmount | 2980.77 |
| Total Drug Medicare PaymentAmount | 2894.87 |
| Total Drug Medicare Standardized Payment Amount | 2894.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1729 |
| Number Of Medicare Beneficiaries With Medical Services | 523 |
| Total Medical Submitted Charge Amount | 204391.01 |
| Total Medical Medicare Allowed Amount | 155859.4 |
| Total Medical Medicare Payment Amount | 108913.49 |
| Total Medical Medicare Standardized Payment Amount | 108379.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 218 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 211 |
| Number Of Non Hispanic White Beneficiaries | 510 |
| Number Of Black or African American Beneficiaries | |
| 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 | 382 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1592 |