| National Provider Identifier [NPI]: | 1366512634 |
| Last Name Of The Provider | KOPACZ |
| First Name Of The Provider | MARCIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | RN,MSN,CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 32270 TELEGRAPH RD |
| Street Address 2 Of The Provider | STE 240 |
| City Of The Provider | BINGHAM FARMS |
| Zip Code Of The Provider | 480252456 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 1534 |
| Number Of Medicare Beneficiaries | 754 |
| Total Submitted Charge Amount | 280380 |
| Total Medicare Allowed Amount | 165299.96 |
| Total Medicare Payment Amount | 129352.4 |
| Total Medicare Standardized Payment Amount | 147711.78 |
| 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 | 1534 |
| Number Of Medicare Beneficiaries With Medical Services | 754 |
| Total Medical Submitted Charge Amount | 280380 |
| Total Medical Medicare Allowed Amount | 165299.96 |
| Total Medical Medicare Payment Amount | 129352.4 |
| Total Medical Medicare Standardized Payment Amount | 147711.78 |
| Average Age Of Beneficiaries | 83 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 397 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 629 |
| Number Of Black or African American Beneficiaries | 109 |
| 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 | 503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 30 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.2997 |