| National Provider Identifier [NPI]: | 1659306629 |
| Last Name Of The Provider | BOCHENEK |
| First Name Of The Provider | KYZYSZTOF |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2722 MERRILEE DR |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314400 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 4888 |
| Number Of Medicare Beneficiaries | 1785 |
| Total Submitted Charge Amount | 1066255.25 |
| Total Medicare Allowed Amount | 183846.48 |
| Total Medicare Payment Amount | 138374.19 |
| Total Medicare Standardized Payment Amount | 132960.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2250 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2158.25 |
| Total Drug Medicare AllowedAmount | 667.81 |
| Total Drug Medicare PaymentAmount | 506.81 |
| Total Drug Medicare Standardized Payment Amount | 506.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 2638 |
| Number Of Medicare Beneficiaries With Medical Services | 1784 |
| Total Medical Submitted Charge Amount | 1064097 |
| Total Medical Medicare Allowed Amount | 183178.67 |
| Total Medical Medicare Payment Amount | 137867.38 |
| Total Medical Medicare Standardized Payment Amount | 132453.82 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 603 |
| Number Of Beneficiaries Age 75 to 84 | 597 |
| Number Of Beneficiaries Age Greater 84 | 430 |
| Number Of Female Beneficiaries | 1036 |
| Number Of Male Beneficiaries | 749 |
| Number Of Non Hispanic White Beneficiaries | 1394 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | 166 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1496 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 289 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 29 |
| Average HCC Risk Score Of Beneficiaries | 1.4926 |