| National Provider Identifier [NPI]: | 1417902008 |
| Last Name Of The Provider | JANSYN |
| First Name Of The Provider | ELLEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 602 MICHIGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOLLAND |
| Zip Code Of The Provider | 494234918 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 1702 |
| Number Of Medicare Beneficiaries | 748 |
| Total Submitted Charge Amount | 270676 |
| Total Medicare Allowed Amount | 138900.85 |
| Total Medicare Payment Amount | 102205.9 |
| Total Medicare Standardized Payment Amount | 108024.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 6693 |
| Total Drug Medicare AllowedAmount | 3264.97 |
| Total Drug Medicare PaymentAmount | 2559.72 |
| Total Drug Medicare Standardized Payment Amount | 2559.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 1609 |
| Number Of Medicare Beneficiaries With Medical Services | 746 |
| Total Medical Submitted Charge Amount | 263983 |
| Total Medical Medicare Allowed Amount | 135635.88 |
| Total Medical Medicare Payment Amount | 99646.18 |
| Total Medical Medicare Standardized Payment Amount | 105464.65 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 228 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 385 |
| Number Of Male Beneficiaries | 363 |
| Number Of Non Hispanic White Beneficiaries | 675 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 611 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5438 |