National Provider Identifier [NPI]: |
1710952270 |
Last Name Of The Provider |
CZERWINSKI |
First Name Of The Provider |
WITOLD |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 SIDNEY ST |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
BATESVILLE |
Zip Code Of The Provider |
725017203 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
4999 |
Number Of Medicare Beneficiaries |
475 |
Total Submitted Charge Amount |
489575 |
Total Medicare Allowed Amount |
352330.1 |
Total Medicare Payment Amount |
273070.64 |
Total Medicare Standardized Payment Amount |
287472.71 |
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 |
16 |
Number Of Medical Services |
4999 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
489575 |
Total Medical Medicare Allowed Amount |
352330.1 |
Total Medical Medicare Payment Amount |
273070.64 |
Total Medical Medicare Standardized Payment Amount |
287472.71 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
284 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
445 |
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 |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
310 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
73 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.874 |