| National Provider Identifier [NPI]: | 1962459701 |
| Last Name Of The Provider | SZCZUPAK |
| First Name Of The Provider | WALDEMAR |
| 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 | 116 INTERSTATE PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADFORD |
| Zip Code Of The Provider | 167011036 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 734 |
| Number Of Medicare Beneficiaries | 603 |
| Total Submitted Charge Amount | 711150 |
| Total Medicare Allowed Amount | 103164.62 |
| Total Medicare Payment Amount | 78984.29 |
| Total Medicare Standardized Payment Amount | 79733.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 734 |
| Number Of Medicare Beneficiaries With Medical Services | 603 |
| Total Medical Submitted Charge Amount | 711150 |
| Total Medical Medicare Allowed Amount | 103164.62 |
| Total Medical Medicare Payment Amount | 78984.29 |
| Total Medical Medicare Standardized Payment Amount | 79733.93 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 274 |
| 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 | 345 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 258 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5272 |