| National Provider Identifier [NPI]: | 1467482497 |
| Last Name Of The Provider | KITOWSKI |
| First Name Of The Provider | JEROME |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 610 W ADAMS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLACK RIVER FALLS |
| Zip Code Of The Provider | 546159010 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 4465 |
| Number Of Medicare Beneficiaries | 242 |
| Total Submitted Charge Amount | 506034 |
| Total Medicare Allowed Amount | 120502 |
| Total Medicare Payment Amount | 92674.89 |
| Total Medicare Standardized Payment Amount | 95401.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 707 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 48040 |
| Total Drug Medicare AllowedAmount | 18446.32 |
| Total Drug Medicare PaymentAmount | 15937.75 |
| Total Drug Medicare Standardized Payment Amount | 15937.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 152 |
| Number Of Medical Services | 3758 |
| Number Of Medicare Beneficiaries With Medical Services | 242 |
| Total Medical Submitted Charge Amount | 457994 |
| Total Medical Medicare Allowed Amount | 102055.68 |
| Total Medical Medicare Payment Amount | 76737.14 |
| Total Medical Medicare Standardized Payment Amount | 79464.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 116 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1431 |