| National Provider Identifier [NPI]: | 1093816316 |
| Last Name Of The Provider | KOZMINSKI |
| First Name Of The Provider | MIKE |
| 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 | 901 HEARTLAND RD |
| Street Address 2 Of The Provider | SUITE 1800 |
| City Of The Provider | SAINT JOSEPH |
| Zip Code Of The Provider | 645066200 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 31571 |
| Number Of Medicare Beneficiaries | 1503 |
| Total Submitted Charge Amount | 3915833.8 |
| Total Medicare Allowed Amount | 1011915.97 |
| Total Medicare Payment Amount | 763494.87 |
| Total Medicare Standardized Payment Amount | 804906.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 18888 |
| Number Of Medicare Beneficiaries With Drug Services | 178 |
| Total Drug Submitted ChargeAmount | 608722.8 |
| Total Drug Medicare AllowedAmount | 324827.66 |
| Total Drug Medicare PaymentAmount | 254613.34 |
| Total Drug Medicare Standardized Payment Amount | 254613.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 12683 |
| Number Of Medicare Beneficiaries With Medical Services | 1503 |
| Total Medical Submitted Charge Amount | 3307111 |
| Total Medical Medicare Allowed Amount | 687088.31 |
| Total Medical Medicare Payment Amount | 508881.53 |
| Total Medical Medicare Standardized Payment Amount | 550293.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 569 |
| Number Of Beneficiaries Age 75 to 84 | 492 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 453 |
| Number Of Male Beneficiaries | 1050 |
| Number Of Non Hispanic White Beneficiaries | 1441 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1243 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 260 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2482 |