| National Provider Identifier [NPI]: | 1467522961 |
| Last Name Of The Provider | TRYCIECKY |
| First Name Of The Provider | EUGENE |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28050 GRAND RIVER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FARMINGTON HILLS |
| Zip Code Of The Provider | 483365919 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 3071 |
| Number Of Medicare Beneficiaries | 1712 |
| Total Submitted Charge Amount | 319925 |
| Total Medicare Allowed Amount | 105387.7 |
| Total Medicare Payment Amount | 78165.16 |
| Total Medicare Standardized Payment Amount | 76880.34 |
| 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 | 149 |
| Number Of Medical Services | 3071 |
| Number Of Medicare Beneficiaries With Medical Services | 1712 |
| Total Medical Submitted Charge Amount | 319925 |
| Total Medical Medicare Allowed Amount | 105387.7 |
| Total Medical Medicare Payment Amount | 78165.16 |
| Total Medical Medicare Standardized Payment Amount | 76880.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 527 |
| Number Of Beneficiaries Age 75 to 84 | 428 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 992 |
| Number Of Male Beneficiaries | 720 |
| Number Of Non Hispanic White Beneficiaries | 1033 |
| Number Of Black or African American Beneficiaries | 631 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 594 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3759 |