| National Provider Identifier [NPI]: | 1285651869 |
| Last Name Of The Provider | BUITEWEG |
| First Name Of The Provider | JOHANNES |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 S CRAPO ST |
| Street Address 2 Of The Provider | SUITE F |
| City Of The Provider | MT PLEASANT |
| Zip Code Of The Provider | 488582961 |
| 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 | 206 |
| Number Of Services | 4389 |
| Number Of Medicare Beneficiaries | 2272 |
| Total Submitted Charge Amount | 351321 |
| Total Medicare Allowed Amount | 155018.48 |
| Total Medicare Payment Amount | 118702.66 |
| Total Medicare Standardized Payment Amount | 123030.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 243 |
| Total Drug Medicare AllowedAmount | 2.32 |
| Total Drug Medicare PaymentAmount | 1.88 |
| Total Drug Medicare Standardized Payment Amount | 1.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 4377 |
| Number Of Medicare Beneficiaries With Medical Services | 2272 |
| Total Medical Submitted Charge Amount | 351078 |
| Total Medical Medicare Allowed Amount | 155016.16 |
| Total Medical Medicare Payment Amount | 118700.78 |
| Total Medical Medicare Standardized Payment Amount | 123028.96 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 790 |
| Number Of Beneficiaries Age 75 to 84 | 670 |
| Number Of Beneficiaries Age Greater 84 | 313 |
| Number Of Female Beneficiaries | 1440 |
| Number Of Male Beneficiaries | 832 |
| Number Of Non Hispanic White Beneficiaries | 2146 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1604 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 668 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6163 |