National Provider Identifier [NPI]: |
1568475325 |
Last Name Of The Provider |
WITTMANN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1261 S TAMIAMI TRL |
Street Address 2 Of The Provider |
|
City Of The Provider |
SARASOTA |
Zip Code Of The Provider |
342392219 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
1020 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
750102.5 |
Total Medicare Allowed Amount |
135610.62 |
Total Medicare Payment Amount |
105609.16 |
Total Medicare Standardized Payment Amount |
103505.01 |
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 |
112 |
Number Of Medical Services |
1020 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
750102.5 |
Total Medical Medicare Allowed Amount |
135610.62 |
Total Medical Medicare Payment Amount |
105609.16 |
Total Medical Medicare Standardized Payment Amount |
103505.01 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
266 |
Number Of Non Hispanic White Beneficiaries |
454 |
Number Of Black or African American Beneficiaries |
16 |
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 |
429 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6694 |