| National Provider Identifier [NPI]: | 1588917066 |
| Last Name Of The Provider | DZUBATY |
| First Name Of The Provider | TANYA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 75 KINGS HIGHWAY CUTOFF |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRFIELD |
| Zip Code Of The Provider | 068245340 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 448 |
| Number Of Medicare Beneficiaries | 85 |
| Total Submitted Charge Amount | 29502 |
| Total Medicare Allowed Amount | 11672.28 |
| Total Medicare Payment Amount | 8625.59 |
| Total Medicare Standardized Payment Amount | 9257.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 300 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 4720 |
| Total Drug Medicare AllowedAmount | 2259.61 |
| Total Drug Medicare PaymentAmount | 1771.56 |
| Total Drug Medicare Standardized Payment Amount | 1771.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 148 |
| Number Of Medicare Beneficiaries With Medical Services | 85 |
| Total Medical Submitted Charge Amount | 24782 |
| Total Medical Medicare Allowed Amount | 9412.67 |
| Total Medical Medicare Payment Amount | 6854.03 |
| Total Medical Medicare Standardized Payment Amount | 7485.5 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 55 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 66 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.089 |