| National Provider Identifier [NPI]: | 1639171754 |
| Last Name Of The Provider | JANICEK |
| First Name Of The Provider | MIKE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10197 N 92ND ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852584560 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gynecological/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 107115 |
| Number Of Medicare Beneficiaries | 394 |
| Total Submitted Charge Amount | 4852757.01 |
| Total Medicare Allowed Amount | 1263062.45 |
| Total Medicare Payment Amount | 966886.26 |
| Total Medicare Standardized Payment Amount | 962889.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 31 |
| Number Of Drug Services | 102893 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 3681727 |
| Total Drug Medicare AllowedAmount | 922386.84 |
| Total Drug Medicare PaymentAmount | 705719.07 |
| Total Drug Medicare Standardized Payment Amount | 705719.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 4222 |
| Number Of Medicare Beneficiaries With Medical Services | 394 |
| Total Medical Submitted Charge Amount | 1171030.01 |
| Total Medical Medicare Allowed Amount | 340675.61 |
| Total Medical Medicare Payment Amount | 261167.19 |
| Total Medical Medicare Standardized Payment Amount | 257170.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 251 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 394 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 363 |
| Number Of Black or African American Beneficiaries | |
| 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 | 367 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3124 |