| National Provider Identifier [NPI]: | 1770535585 |
| Last Name Of The Provider | BEREZNIAK |
| First Name Of The Provider | MARA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11400 PLEASANT VALLEY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PENN VALLEY |
| Zip Code Of The Provider | 959469001 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1771 |
| Number Of Medicare Beneficiaries | 429 |
| Total Submitted Charge Amount | 136943.98 |
| Total Medicare Allowed Amount | 122291.57 |
| Total Medicare Payment Amount | 85790.63 |
| Total Medicare Standardized Payment Amount | 82800.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 265 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 8130.98 |
| Total Drug Medicare AllowedAmount | 2672.68 |
| Total Drug Medicare PaymentAmount | 2483.98 |
| Total Drug Medicare Standardized Payment Amount | 2483.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1506 |
| Number Of Medicare Beneficiaries With Medical Services | 429 |
| Total Medical Submitted Charge Amount | 128813 |
| Total Medical Medicare Allowed Amount | 119618.89 |
| Total Medical Medicare Payment Amount | 83306.65 |
| Total Medical Medicare Standardized Payment Amount | 80316.05 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 234 |
| Number Of Male Beneficiaries | 195 |
| Number Of Non Hispanic White Beneficiaries | 409 |
| 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 | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9608 |