| National Provider Identifier [NPI]: | 1720183742 |
| Last Name Of The Provider | KAMINSKI |
| First Name Of The Provider | MAREK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15 E 11TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIBERAL |
| Zip Code Of The Provider | 679012720 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 6081 |
| Number Of Medicare Beneficiaries | 1020 |
| Total Submitted Charge Amount | 551785 |
| Total Medicare Allowed Amount | 418568.25 |
| Total Medicare Payment Amount | 302261.4 |
| Total Medicare Standardized Payment Amount | 311782.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 102 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1418 |
| Total Drug Medicare AllowedAmount | 182.41 |
| Total Drug Medicare PaymentAmount | 103.2 |
| Total Drug Medicare Standardized Payment Amount | 103.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 5979 |
| Number Of Medicare Beneficiaries With Medical Services | 1020 |
| Total Medical Submitted Charge Amount | 550367 |
| Total Medical Medicare Allowed Amount | 418385.84 |
| Total Medical Medicare Payment Amount | 302158.2 |
| Total Medical Medicare Standardized Payment Amount | 311679.67 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 411 |
| Number Of Beneficiaries Age 75 to 84 | 381 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 471 |
| Number Of Male Beneficiaries | 549 |
| Number Of Non Hispanic White Beneficiaries | 967 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 955 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9499 |