| National Provider Identifier [NPI]: | 1831134931 |
| Last Name Of The Provider | HYSZCZAK |
| First Name Of The Provider | ROMAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1234 NAPIER AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST JOSEPH |
| Zip Code Of The Provider | 49085 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 231 |
| Number Of Services | 6739 |
| Number Of Medicare Beneficiaries | 3869 |
| Total Submitted Charge Amount | 985109 |
| Total Medicare Allowed Amount | 274103.5 |
| Total Medicare Payment Amount | 198123.37 |
| Total Medicare Standardized Payment Amount | 212482.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 231 |
| Number Of Medical Services | 6739 |
| Number Of Medicare Beneficiaries With Medical Services | 3869 |
| Total Medical Submitted Charge Amount | 985109 |
| Total Medical Medicare Allowed Amount | 274103.5 |
| Total Medical Medicare Payment Amount | 198123.37 |
| Total Medical Medicare Standardized Payment Amount | 212482.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 862 |
| Number Of Beneficiaries Age 65 to 74 | 1251 |
| Number Of Beneficiaries Age 75 to 84 | 1074 |
| Number Of Beneficiaries Age Greater 84 | 682 |
| Number Of Female Beneficiaries | 2224 |
| Number Of Male Beneficiaries | 1645 |
| Number Of Non Hispanic White Beneficiaries | 3090 |
| Number Of Black or African American Beneficiaries | 662 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1280 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7687 |