| National Provider Identifier [NPI]: | 1730137910 |
| Last Name Of The Provider | WISEMAN |
| First Name Of The Provider | RICKEY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2881 HYDE PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342393228 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 7329 |
| Number Of Medicare Beneficiaries | 929 |
| Total Submitted Charge Amount | 591558 |
| Total Medicare Allowed Amount | 288915.52 |
| Total Medicare Payment Amount | 221675.86 |
| Total Medicare Standardized Payment Amount | 222450.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 113 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 4247 |
| Total Drug Medicare AllowedAmount | 2178.6 |
| Total Drug Medicare PaymentAmount | 2094.24 |
| Total Drug Medicare Standardized Payment Amount | 2094.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 7216 |
| Number Of Medicare Beneficiaries With Medical Services | 929 |
| Total Medical Submitted Charge Amount | 587311 |
| Total Medical Medicare Allowed Amount | 286736.92 |
| Total Medical Medicare Payment Amount | 219581.62 |
| Total Medical Medicare Standardized Payment Amount | 220356.74 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 282 |
| Number Of Beneficiaries Age 75 to 84 | 292 |
| Number Of Beneficiaries Age Greater 84 | 328 |
| Number Of Female Beneficiaries | 551 |
| Number Of Male Beneficiaries | 378 |
| Number Of Non Hispanic White Beneficiaries | 882 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 845 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2546 |