| National Provider Identifier [NPI]: | 1194783761 |
| Last Name Of The Provider | WIENER |
| First Name Of The Provider | HARVEY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 S ASHLEY DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336025304 |
| 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 | 271 |
| Number Of Services | 11881 |
| Number Of Medicare Beneficiaries | 5560 |
| Total Submitted Charge Amount | 1763322 |
| Total Medicare Allowed Amount | 290650.46 |
| Total Medicare Payment Amount | 228778.75 |
| Total Medicare Standardized Payment Amount | 228139.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2143 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 2547 |
| Total Drug Medicare AllowedAmount | 540.75 |
| Total Drug Medicare PaymentAmount | 423.9 |
| Total Drug Medicare Standardized Payment Amount | 423.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 268 |
| Number Of Medical Services | 9738 |
| Number Of Medicare Beneficiaries With Medical Services | 5559 |
| Total Medical Submitted Charge Amount | 1760775 |
| Total Medical Medicare Allowed Amount | 290109.71 |
| Total Medical Medicare Payment Amount | 228354.85 |
| Total Medical Medicare Standardized Payment Amount | 227715.18 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 747 |
| Number Of Beneficiaries Age 65 to 74 | 1657 |
| Number Of Beneficiaries Age 75 to 84 | 1770 |
| Number Of Beneficiaries Age Greater 84 | 1386 |
| Number Of Female Beneficiaries | 3495 |
| Number Of Male Beneficiaries | 2065 |
| Number Of Non Hispanic White Beneficiaries | 4959 |
| Number Of Black or African American Beneficiaries | 252 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 256 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 4137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1423 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9966 |