| National Provider Identifier [NPI]: | 1093977985 |
| Last Name Of The Provider | KOPITZKI |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5701 BOW POINTE DR STE 215 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSTON |
| Zip Code Of The Provider | 483465400 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 2764 |
| Number Of Medicare Beneficiaries | 561 |
| Total Submitted Charge Amount | 785114 |
| Total Medicare Allowed Amount | 454915.4 |
| Total Medicare Payment Amount | 346662.69 |
| Total Medicare Standardized Payment Amount | 325250.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1710 |
| Total Drug Medicare AllowedAmount | 1182.14 |
| Total Drug Medicare PaymentAmount | 925.43 |
| Total Drug Medicare Standardized Payment Amount | 925.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 2701 |
| Number Of Medicare Beneficiaries With Medical Services | 561 |
| Total Medical Submitted Charge Amount | 783404 |
| Total Medical Medicare Allowed Amount | 453733.26 |
| Total Medical Medicare Payment Amount | 345737.26 |
| Total Medical Medicare Standardized Payment Amount | 324324.72 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 192 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 336 |
| Number Of Non Hispanic White Beneficiaries | 543 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1258 |