| National Provider Identifier [NPI]: | 1467533521 |
| Last Name Of The Provider | KUJAWSKI |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | B1 FLOOR CANCER & GERIATRICS CTR RECP B |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095911 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 312 |
| Number Of Medicare Beneficiaries | 126 |
| Total Submitted Charge Amount | 58056 |
| Total Medicare Allowed Amount | 37284.03 |
| Total Medicare Payment Amount | 27669.18 |
| Total Medicare Standardized Payment Amount | 27714.16 |
| 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 | 11 |
| Number Of Medical Services | 312 |
| Number Of Medicare Beneficiaries With Medical Services | 126 |
| Total Medical Submitted Charge Amount | 58056 |
| Total Medical Medicare Allowed Amount | 37284.03 |
| Total Medical Medicare Payment Amount | 27669.18 |
| Total Medical Medicare Standardized Payment Amount | 27714.16 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 110 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.6867 |