| National Provider Identifier [NPI]: | 1659345056 |
| Last Name Of The Provider | STACHECKI |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5885 S MAIN ST STE 3 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSTON |
| Zip Code Of The Provider | 483462981 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1255 |
| Number Of Medicare Beneficiaries | 283 |
| Total Submitted Charge Amount | 111846 |
| Total Medicare Allowed Amount | 79064.15 |
| Total Medicare Payment Amount | 59891.84 |
| Total Medicare Standardized Payment Amount | 58512.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 151 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 4883 |
| Total Drug Medicare AllowedAmount | 4105.85 |
| Total Drug Medicare PaymentAmount | 4011.71 |
| Total Drug Medicare Standardized Payment Amount | 4011.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1104 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 106963 |
| Total Medical Medicare Allowed Amount | 74958.3 |
| Total Medical Medicare Payment Amount | 55880.13 |
| Total Medical Medicare Standardized Payment Amount | 54500.37 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 257 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 271 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9539 |