| National Provider Identifier [NPI]: | 1891753943 |
| Last Name Of The Provider | KWIECINSKI |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2340 S HIGHLAND AVE |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | LOMBARD |
| Zip Code Of The Provider | 601485371 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 4039 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 399547 |
| Total Medicare Allowed Amount | 193547.45 |
| Total Medicare Payment Amount | 147408.3 |
| Total Medicare Standardized Payment Amount | 140463.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1251 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 36754 |
| Total Drug Medicare AllowedAmount | 18900.99 |
| Total Drug Medicare PaymentAmount | 15172.81 |
| Total Drug Medicare Standardized Payment Amount | 15172.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 2788 |
| Number Of Medicare Beneficiaries With Medical Services | 523 |
| Total Medical Submitted Charge Amount | 362793 |
| Total Medical Medicare Allowed Amount | 174646.46 |
| Total Medical Medicare Payment Amount | 132235.49 |
| Total Medical Medicare Standardized Payment Amount | 125291.07 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 271 |
| Number Of Male Beneficiaries | 252 |
| Number Of Non Hispanic White Beneficiaries | 494 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 495 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3095 |