| National Provider Identifier [NPI]: | 1952314122 |
| Last Name Of The Provider | WADOWSKI |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22250 PROVIDENCE DRIVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 48075 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1358 |
| Number Of Medicare Beneficiaries | 747 |
| Total Submitted Charge Amount | 410655 |
| Total Medicare Allowed Amount | 207571.44 |
| Total Medicare Payment Amount | 145237.06 |
| Total Medicare Standardized Payment Amount | 145179.95 |
| 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 | 19 |
| Number Of Medical Services | 1358 |
| Number Of Medicare Beneficiaries With Medical Services | 747 |
| Total Medical Submitted Charge Amount | 410655 |
| Total Medical Medicare Allowed Amount | 207571.44 |
| Total Medical Medicare Payment Amount | 145237.06 |
| Total Medical Medicare Standardized Payment Amount | 145179.95 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 350 |
| Number Of Beneficiaries Age 75 to 84 | 218 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 476 |
| Number Of Male Beneficiaries | 271 |
| Number Of Non Hispanic White Beneficiaries | 464 |
| Number Of Black or African American Beneficiaries | 242 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| 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 | 641 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2205 |