| National Provider Identifier [NPI]: | 1528247392 |
| Last Name Of The Provider | NOSACEK |
| First Name Of The Provider | IVAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3006 MITCHELLVILLE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOWIE |
| Zip Code Of The Provider | 207161300 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 5583 |
| Number Of Medicare Beneficiaries | 1091 |
| Total Submitted Charge Amount | 471607 |
| Total Medicare Allowed Amount | 331833.29 |
| Total Medicare Payment Amount | 241400 |
| Total Medicare Standardized Payment Amount | 218534.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 3750 |
| Total Drug Medicare AllowedAmount | 185.84 |
| Total Drug Medicare PaymentAmount | 143.52 |
| Total Drug Medicare Standardized Payment Amount | 143.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 5436 |
| Number Of Medicare Beneficiaries With Medical Services | 1091 |
| Total Medical Submitted Charge Amount | 467857 |
| Total Medical Medicare Allowed Amount | 331647.45 |
| Total Medical Medicare Payment Amount | 241256.48 |
| Total Medical Medicare Standardized Payment Amount | 218390.7 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 310 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 325 |
| Number Of Female Beneficiaries | 716 |
| Number Of Male Beneficiaries | 375 |
| Number Of Non Hispanic White Beneficiaries | 809 |
| Number Of Black or African American Beneficiaries | 254 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| 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 | 1027 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.4633 |