| National Provider Identifier [NPI]: | 1013971563 |
| Last Name Of The Provider | WISTER |
| First Name Of The Provider | MILAN |
| 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 | 2 HAMILL RD |
| Street Address 2 Of The Provider | SUITE 222 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212101806 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 7934 |
| Number Of Medicare Beneficiaries | 803 |
| Total Submitted Charge Amount | 827568.05 |
| Total Medicare Allowed Amount | 419905.51 |
| Total Medicare Payment Amount | 306179.17 |
| Total Medicare Standardized Payment Amount | 288758.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 2025 |
| Number Of Medicare Beneficiaries With Drug Services | 257 |
| Total Drug Submitted ChargeAmount | 74494.55 |
| Total Drug Medicare AllowedAmount | 35023.42 |
| Total Drug Medicare PaymentAmount | 29093.03 |
| Total Drug Medicare Standardized Payment Amount | 29093.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 5909 |
| Number Of Medicare Beneficiaries With Medical Services | 803 |
| Total Medical Submitted Charge Amount | 753073.5 |
| Total Medical Medicare Allowed Amount | 384882.09 |
| Total Medical Medicare Payment Amount | 277086.14 |
| Total Medical Medicare Standardized Payment Amount | 259665.27 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 265 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 500 |
| Number Of Male Beneficiaries | 303 |
| Number Of Non Hispanic White Beneficiaries | 629 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 674 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3172 |