| National Provider Identifier [NPI]: | 1346220647 |
| Last Name Of The Provider | KAZAKOFF |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 90 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 064573649 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 695 |
| Number Of Medicare Beneficiaries | 269 |
| Total Submitted Charge Amount | 93293 |
| Total Medicare Allowed Amount | 50726.67 |
| Total Medicare Payment Amount | 37768.12 |
| Total Medicare Standardized Payment Amount | 35391.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 60 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 2081 |
| Total Drug Medicare AllowedAmount | 913.13 |
| Total Drug Medicare PaymentAmount | 884.08 |
| Total Drug Medicare Standardized Payment Amount | 884.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 635 |
| Number Of Medicare Beneficiaries With Medical Services | 269 |
| Total Medical Submitted Charge Amount | 91212 |
| Total Medical Medicare Allowed Amount | 49813.54 |
| Total Medical Medicare Payment Amount | 36884.04 |
| Total Medical Medicare Standardized Payment Amount | 34507.27 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 217 |
| Number Of Black or African American Beneficiaries | 31 |
| 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 | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4896 |