| National Provider Identifier [NPI]: | 1265412308 |
| Last Name Of The Provider | WITTENSTEIN |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 WATERMAN WAY |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPT |
| City Of The Provider | TAVARES |
| Zip Code Of The Provider | 327785266 |
| 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 | 228 |
| Number Of Services | 7154 |
| Number Of Medicare Beneficiaries | 4072 |
| Total Submitted Charge Amount | 853715 |
| Total Medicare Allowed Amount | 230996.14 |
| Total Medicare Payment Amount | 175420.46 |
| Total Medicare Standardized Payment Amount | 174551.84 |
| 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 | 228 |
| Number Of Medical Services | 7154 |
| Number Of Medicare Beneficiaries With Medical Services | 4072 |
| Total Medical Submitted Charge Amount | 853715 |
| Total Medical Medicare Allowed Amount | 230996.14 |
| Total Medical Medicare Payment Amount | 175420.46 |
| Total Medical Medicare Standardized Payment Amount | 174551.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 447 |
| Number Of Beneficiaries Age 65 to 74 | 1443 |
| Number Of Beneficiaries Age 75 to 84 | 1396 |
| Number Of Beneficiaries Age Greater 84 | 786 |
| Number Of Female Beneficiaries | 2454 |
| Number Of Male Beneficiaries | 1618 |
| Number Of Non Hispanic White Beneficiaries | 3711 |
| Number Of Black or African American Beneficiaries | 202 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 103 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3336 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 736 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6932 |