| National Provider Identifier [NPI]: | 1306838404 |
| Last Name Of The Provider | SZYMANSKI |
| First Name Of The Provider | SALLY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5340 PLYMOUTH RD |
| Street Address 2 Of The Provider | SUITE 207 |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481059341 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 3911 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 135322.15 |
| Total Medicare Allowed Amount | 82254.62 |
| Total Medicare Payment Amount | 59945.22 |
| Total Medicare Standardized Payment Amount | 59251.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3206 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 27308.78 |
| Total Drug Medicare AllowedAmount | 25825.6 |
| Total Drug Medicare PaymentAmount | 19983.21 |
| Total Drug Medicare Standardized Payment Amount | 19983.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 705 |
| Number Of Medicare Beneficiaries With Medical Services | 185 |
| Total Medical Submitted Charge Amount | 108013.37 |
| Total Medical Medicare Allowed Amount | 56429.02 |
| Total Medical Medicare Payment Amount | 39962.01 |
| Total Medical Medicare Standardized Payment Amount | 39268.5 |
| Average Age Of Beneficiaries | 48 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 133 |
| Number Of Black or African American Beneficiaries | 36 |
| 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 | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 152 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 41 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2937 |