| National Provider Identifier [NPI]: | 1801805528 |
| Last Name Of The Provider | OSWALD |
| First Name Of The Provider | THEODORE |
| 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 | 2845 US HIGHWAY 2/41 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARK RIVER |
| Zip Code Of The Provider | 498079661 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 4511 |
| Number Of Medicare Beneficiaries | 1024 |
| Total Submitted Charge Amount | 366356 |
| Total Medicare Allowed Amount | 258178.92 |
| Total Medicare Payment Amount | 181367.94 |
| Total Medicare Standardized Payment Amount | 193326.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1164 |
| Number Of Medicare Beneficiaries With Drug Services | 453 |
| Total Drug Submitted ChargeAmount | 32987 |
| Total Drug Medicare AllowedAmount | 12140.89 |
| Total Drug Medicare PaymentAmount | 10534.28 |
| Total Drug Medicare Standardized Payment Amount | 10534.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3347 |
| Number Of Medicare Beneficiaries With Medical Services | 1017 |
| Total Medical Submitted Charge Amount | 333369 |
| Total Medical Medicare Allowed Amount | 246038.03 |
| Total Medical Medicare Payment Amount | 170833.66 |
| Total Medical Medicare Standardized Payment Amount | 182792.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 456 |
| Number Of Beneficiaries Age 75 to 84 | 283 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 521 |
| Number Of Male Beneficiaries | 503 |
| Number Of Non Hispanic White Beneficiaries | 995 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 865 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8998 |