| National Provider Identifier [NPI]: | 1376732016 |
| Last Name Of The Provider | SYBESMA |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 183 PEACE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT JOSEPH |
| Zip Code Of The Provider | 490859146 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 4399 |
| Number Of Medicare Beneficiaries | 496 |
| Total Submitted Charge Amount | 1013775 |
| Total Medicare Allowed Amount | 358785.86 |
| Total Medicare Payment Amount | 270810.35 |
| Total Medicare Standardized Payment Amount | 279047.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2100 |
| Number Of Medicare Beneficiaries With Drug Services | 212 |
| Total Drug Submitted ChargeAmount | 35538 |
| Total Drug Medicare AllowedAmount | 10255.61 |
| Total Drug Medicare PaymentAmount | 7875.22 |
| Total Drug Medicare Standardized Payment Amount | 7875.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 2299 |
| Number Of Medicare Beneficiaries With Medical Services | 496 |
| Total Medical Submitted Charge Amount | 978237 |
| Total Medical Medicare Allowed Amount | 348530.25 |
| Total Medical Medicare Payment Amount | 262935.13 |
| Total Medical Medicare Standardized Payment Amount | 271172.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | 424 |
| Number Of Black or African American Beneficiaries | 56 |
| 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 | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2944 |