| National Provider Identifier [NPI]: | 1619294246 |
| Last Name Of The Provider | KATZEN |
| First Name Of The Provider | MELVYN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3155 HARBOR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT CHARLOTTE |
| Zip Code Of The Provider | 339526729 |
| 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 | 127 |
| Number Of Services | 6734 |
| Number Of Medicare Beneficiaries | 891 |
| Total Submitted Charge Amount | 526949.1 |
| Total Medicare Allowed Amount | 171860.25 |
| Total Medicare Payment Amount | 132026.43 |
| Total Medicare Standardized Payment Amount | 135410.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5123 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 9974.1 |
| Total Drug Medicare AllowedAmount | 1992.21 |
| Total Drug Medicare PaymentAmount | 1500.85 |
| Total Drug Medicare Standardized Payment Amount | 1500.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 1611 |
| Number Of Medicare Beneficiaries With Medical Services | 889 |
| Total Medical Submitted Charge Amount | 516975 |
| Total Medical Medicare Allowed Amount | 169868.04 |
| Total Medical Medicare Payment Amount | 130525.58 |
| Total Medical Medicare Standardized Payment Amount | 133909.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 382 |
| Number Of Beneficiaries Age 75 to 84 | 333 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 605 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 818 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 825 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0559 |