| National Provider Identifier [NPI]: | 1578632147 |
| Last Name Of The Provider | NIEDZWIECKI |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2730 N MCMULLEN BOOTH RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337613325 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 279 |
| Number Of Services | 28359 |
| Number Of Medicare Beneficiaries | 827 |
| Total Submitted Charge Amount | 6480024.88 |
| Total Medicare Allowed Amount | 1933727.62 |
| Total Medicare Payment Amount | 1510660.21 |
| Total Medicare Standardized Payment Amount | 1556981.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 22114 |
| Number Of Medicare Beneficiaries With Drug Services | 414 |
| Total Drug Submitted ChargeAmount | 31883.15 |
| Total Drug Medicare AllowedAmount | 6709.75 |
| Total Drug Medicare PaymentAmount | 5148.77 |
| Total Drug Medicare Standardized Payment Amount | 5148.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 263 |
| Number Of Medical Services | 6245 |
| Number Of Medicare Beneficiaries With Medical Services | 827 |
| Total Medical Submitted Charge Amount | 6448141.73 |
| Total Medical Medicare Allowed Amount | 1927017.87 |
| Total Medical Medicare Payment Amount | 1505511.44 |
| Total Medical Medicare Standardized Payment Amount | 1551832.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 435 |
| Number Of Male Beneficiaries | 392 |
| Number Of Non Hispanic White Beneficiaries | 773 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 720 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0995 |