| National Provider Identifier [NPI]: | 1275894958 | 
| Last Name Of The Provider | WASKIEWICZ | 
| First Name Of The Provider | STEVEN | 
| Middle Initial Of The Provider | K | 
| Credentials Of The Provider | NP | 
| Gender Of The Provider | M | 
| Entity Type Of The Provider | I | 
| Street Address 1 Of The Provider | 125 S KALAMAZOO MALL | 
| Street Address 2 Of The Provider | SUITE 204 | 
| City Of The Provider | KALAMAZOO | 
| Zip Code Of The Provider | 490074832 | 
| State Code Of The Provider | MI | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | Nurse Practitioner | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 10 | 
| Number Of Services | 54 | 
| Number Of Medicare Beneficiaries | 42 | 
| Total Submitted Charge Amount | 7116 | 
| Total Medicare Allowed Amount | 1720.1 | 
| Total Medicare Payment Amount | 1348.94 | 
| Total Medicare Standardized Payment Amount | 1548.78 | 
| 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 | 10 | 
| Number Of Medical Services | 54 | 
| Number Of Medicare Beneficiaries With Medical Services | 42 | 
| Total Medical Submitted Charge Amount | 7116 | 
| Total Medical Medicare Allowed Amount | 1720.1 | 
| Total Medical Medicare Payment Amount | 1348.94 | 
| Total Medical Medicare Standardized Payment Amount | 1548.78 | 
| Average Age Of Beneficiaries | 69 | 
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 16 | 
| Number Of Beneficiaries Age 75 to 84 | 12 | 
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 25 | 
| Number Of Male Beneficiaries | 17 | 
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 25 | 
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 | 
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 33 | 
| Percent Of With Chronic Kidney Disease | 43 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 | 
| Percent Of With Depression | 31 | 
| Percent Of With Diabetes | 40 | 
| Percent Of With Hyperlipidemia | 60 | 
| Percent Of With Hypertension | 74 | 
| Percent Of With Ischemic Heart Disease | 50 | 
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6467 |