| National Provider Identifier [NPI]: | 1497968655 |
| Last Name Of The Provider | MAKSIM |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O., R.PH. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5131 BEACON HILL RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432284442 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1891 |
| Number Of Medicare Beneficiaries | 866 |
| Total Submitted Charge Amount | 228334 |
| Total Medicare Allowed Amount | 112445.67 |
| Total Medicare Payment Amount | 83506.12 |
| Total Medicare Standardized Payment Amount | 86957.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1891 |
| Number Of Medicare Beneficiaries With Medical Services | 866 |
| Total Medical Submitted Charge Amount | 228334 |
| Total Medical Medicare Allowed Amount | 112445.67 |
| Total Medical Medicare Payment Amount | 83506.12 |
| Total Medical Medicare Standardized Payment Amount | 86957.15 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 290 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 484 |
| Number Of Male Beneficiaries | 382 |
| Number Of Non Hispanic White Beneficiaries | 736 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.112 |