| National Provider Identifier [NPI]: | 1831130814 |
| Last Name Of The Provider | WIESEN |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 625 9TH ST N |
| Street Address 2 Of The Provider | SUITE 304 |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341028143 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2199 |
| Number Of Medicare Beneficiaries | 1024 |
| Total Submitted Charge Amount | 1254691 |
| Total Medicare Allowed Amount | 377698.34 |
| Total Medicare Payment Amount | 296617.24 |
| Total Medicare Standardized Payment Amount | 279649.74 |
| 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 | 51 |
| Number Of Medical Services | 2199 |
| Number Of Medicare Beneficiaries With Medical Services | 1024 |
| Total Medical Submitted Charge Amount | 1254691 |
| Total Medical Medicare Allowed Amount | 377698.34 |
| Total Medical Medicare Payment Amount | 296617.24 |
| Total Medical Medicare Standardized Payment Amount | 279649.74 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 413 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 515 |
| Number Of Male Beneficiaries | 509 |
| Number Of Non Hispanic White Beneficiaries | 977 |
| Number Of Black or African American Beneficiaries | |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 991 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0292 |