| National Provider Identifier [NPI]: | 1598753352 |
| Last Name Of The Provider | WOLLETT |
| First Name Of The Provider | FREDRIC |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1818 SW 15TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OCALA |
| Zip Code Of The Provider | 344743548 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 38428 |
| Number Of Medicare Beneficiaries | 5244 |
| Total Submitted Charge Amount | 2446153.03 |
| Total Medicare Allowed Amount | 717776.49 |
| Total Medicare Payment Amount | 568954.14 |
| Total Medicare Standardized Payment Amount | 581459.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 29916 |
| Number Of Medicare Beneficiaries With Drug Services | 360 |
| Total Drug Submitted ChargeAmount | 79802.5 |
| Total Drug Medicare AllowedAmount | 7895.74 |
| Total Drug Medicare PaymentAmount | 6104.47 |
| Total Drug Medicare Standardized Payment Amount | 6104.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 8512 |
| Number Of Medicare Beneficiaries With Medical Services | 5241 |
| Total Medical Submitted Charge Amount | 2366350.53 |
| Total Medical Medicare Allowed Amount | 709880.75 |
| Total Medical Medicare Payment Amount | 562849.67 |
| Total Medical Medicare Standardized Payment Amount | 575354.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 615 |
| Number Of Beneficiaries Age 65 to 74 | 1920 |
| Number Of Beneficiaries Age 75 to 84 | 1852 |
| Number Of Beneficiaries Age Greater 84 | 857 |
| Number Of Female Beneficiaries | 3331 |
| Number Of Male Beneficiaries | 1913 |
| Number Of Non Hispanic White Beneficiaries | 4562 |
| Number Of Black or African American Beneficiaries | 355 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 231 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4308 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 936 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6573 |