| National Provider Identifier [NPI]: | 1861462327 |
| Last Name Of The Provider | CIESIELSKI |
| First Name Of The Provider | MATT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 W CENTRE AVE |
| Street Address 2 Of The Provider | BRONSON FAMILY PRACTICE PORTAGE |
| City Of The Provider | PORTAGE |
| Zip Code Of The Provider | 490244666 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1074 |
| Number Of Medicare Beneficiaries | 326 |
| Total Submitted Charge Amount | 98176 |
| Total Medicare Allowed Amount | 64414.96 |
| Total Medicare Payment Amount | 41753.19 |
| Total Medicare Standardized Payment Amount | 44396.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 3537 |
| Total Drug Medicare AllowedAmount | 2399.98 |
| Total Drug Medicare PaymentAmount | 2311.74 |
| Total Drug Medicare Standardized Payment Amount | 2311.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 950 |
| Number Of Medicare Beneficiaries With Medical Services | 326 |
| Total Medical Submitted Charge Amount | 94639 |
| Total Medical Medicare Allowed Amount | 62014.98 |
| Total Medical Medicare Payment Amount | 39441.45 |
| Total Medical Medicare Standardized Payment Amount | 42084.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | 299 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 278 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1014 |