| National Provider Identifier [NPI]: | 1508805490 |
| Last Name Of The Provider | JASZCZAK |
| First Name Of The Provider | TERESA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2891 E MAPLE RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 480836106 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1826.5 |
| Number Of Medicare Beneficiaries | 191 |
| Total Submitted Charge Amount | 176548.56 |
| Total Medicare Allowed Amount | 117429.34 |
| Total Medicare Payment Amount | 86006.37 |
| Total Medicare Standardized Payment Amount | 81552.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 196.5 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 5510 |
| Total Drug Medicare AllowedAmount | 1975.38 |
| Total Drug Medicare PaymentAmount | 1595.37 |
| Total Drug Medicare Standardized Payment Amount | 1595.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 1630 |
| Number Of Medicare Beneficiaries With Medical Services | 191 |
| Total Medical Submitted Charge Amount | 171038.56 |
| Total Medical Medicare Allowed Amount | 115453.96 |
| Total Medical Medicare Payment Amount | 84411 |
| Total Medical Medicare Standardized Payment Amount | 79956.95 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 152 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.321 |