| National Provider Identifier [NPI]: | 1194798025 |
| Last Name Of The Provider | MAMEROW |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | S69 W15636 JANESVILLE ROAD |
| Street Address 2 Of The Provider | PROHEALTH CARE MEDICAL ASSOCIATES, INC |
| City Of The Provider | MUSKEGO |
| Zip Code Of The Provider | 531507900 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3845 |
| Number Of Medicare Beneficiaries | 1880 |
| Total Submitted Charge Amount | 336981 |
| Total Medicare Allowed Amount | 108603.84 |
| Total Medicare Payment Amount | 78521.21 |
| Total Medicare Standardized Payment Amount | 81812.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 87 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 5707 |
| Total Drug Medicare AllowedAmount | 3918.91 |
| Total Drug Medicare PaymentAmount | 3840.28 |
| Total Drug Medicare Standardized Payment Amount | 3840.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 3758 |
| Number Of Medicare Beneficiaries With Medical Services | 1879 |
| Total Medical Submitted Charge Amount | 331274 |
| Total Medical Medicare Allowed Amount | 104684.93 |
| Total Medical Medicare Payment Amount | 74680.93 |
| Total Medical Medicare Standardized Payment Amount | 77972.66 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 200 |
| Number Of Beneficiaries Age 65 to 74 | 618 |
| Number Of Beneficiaries Age 75 to 84 | 621 |
| Number Of Beneficiaries Age Greater 84 | 441 |
| Number Of Female Beneficiaries | 1052 |
| Number Of Male Beneficiaries | 828 |
| Number Of Non Hispanic White Beneficiaries | 1807 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 291 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5834 |