| National Provider Identifier [NPI]: | 1104852367 |
| Last Name Of The Provider | GLOWNIAK |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24500 NORTHWESTERN HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480752414 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 2658 |
| Number Of Medicare Beneficiaries | 1802 |
| Total Submitted Charge Amount | 262215.5 |
| Total Medicare Allowed Amount | 65942.5 |
| Total Medicare Payment Amount | 51557.77 |
| Total Medicare Standardized Payment Amount | 50347.67 |
| 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 | 111 |
| Number Of Medical Services | 2658 |
| Number Of Medicare Beneficiaries With Medical Services | 1802 |
| Total Medical Submitted Charge Amount | 262215.5 |
| Total Medical Medicare Allowed Amount | 65942.5 |
| Total Medical Medicare Payment Amount | 51557.77 |
| Total Medical Medicare Standardized Payment Amount | 50347.67 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 694 |
| Number Of Beneficiaries Age 65 to 74 | 536 |
| Number Of Beneficiaries Age 75 to 84 | 370 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 1037 |
| Number Of Male Beneficiaries | 765 |
| Number Of Non Hispanic White Beneficiaries | 251 |
| Number Of Black or African American Beneficiaries | 1475 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1192 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 27 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.7892 |