| National Provider Identifier [NPI]: | 1699771386 |
| Last Name Of The Provider | PANEK |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5803 NEAL AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAK PARK HEIGHTS |
| Zip Code Of The Provider | 550822177 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1137 |
| Number Of Medicare Beneficiaries | 256 |
| Total Submitted Charge Amount | 454753 |
| Total Medicare Allowed Amount | 130447.56 |
| Total Medicare Payment Amount | 99153.04 |
| Total Medicare Standardized Payment Amount | 102995.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 319 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 25990 |
| Total Drug Medicare AllowedAmount | 14070.59 |
| Total Drug Medicare PaymentAmount | 10790.2 |
| Total Drug Medicare Standardized Payment Amount | 10790.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 818 |
| Number Of Medicare Beneficiaries With Medical Services | 256 |
| Total Medical Submitted Charge Amount | 428763 |
| Total Medical Medicare Allowed Amount | 116376.97 |
| Total Medical Medicare Payment Amount | 88362.84 |
| Total Medical Medicare Standardized Payment Amount | 92205.63 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 139 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8975 |