| National Provider Identifier [NPI]: | 1316181092 |
| Last Name Of The Provider | WISOTSKY |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2121 MEDICAL PARK DR |
| Street Address 2 Of The Provider | STE 3 |
| City Of The Provider | SILVER SPRING |
| Zip Code Of The Provider | 209024054 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 15057 |
| Number Of Medicare Beneficiaries | 4488 |
| Total Submitted Charge Amount | 1584074.36 |
| Total Medicare Allowed Amount | 480152.25 |
| Total Medicare Payment Amount | 375162.04 |
| Total Medicare Standardized Payment Amount | 334812.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6578 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 8206.36 |
| Total Drug Medicare AllowedAmount | 2047.94 |
| Total Drug Medicare PaymentAmount | 1420.49 |
| Total Drug Medicare Standardized Payment Amount | 1420.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 8479 |
| Number Of Medicare Beneficiaries With Medical Services | 4488 |
| Total Medical Submitted Charge Amount | 1575868 |
| Total Medical Medicare Allowed Amount | 478104.31 |
| Total Medical Medicare Payment Amount | 373741.55 |
| Total Medical Medicare Standardized Payment Amount | 333392.08 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 492 |
| Number Of Beneficiaries Age 65 to 74 | 1466 |
| Number Of Beneficiaries Age 75 to 84 | 1412 |
| Number Of Beneficiaries Age Greater 84 | 1118 |
| Number Of Female Beneficiaries | 2940 |
| Number Of Male Beneficiaries | 1548 |
| Number Of Non Hispanic White Beneficiaries | 2348 |
| Number Of Black or African American Beneficiaries | 1476 |
| Number Of AsianPacific Islander Beneficiaries | 261 |
| Number Of Hispanic Beneficiaries | 303 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3467 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1021 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7593 |