| National Provider Identifier [NPI]: | 1295730414 |
| Last Name Of The Provider | WARTMAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13403 BOYETTE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERVIEW |
| Zip Code Of The Provider | 335698742 |
| 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 | 128 |
| Number Of Services | 11499 |
| Number Of Medicare Beneficiaries | 944 |
| Total Submitted Charge Amount | 689673.3 |
| Total Medicare Allowed Amount | 479039.53 |
| Total Medicare Payment Amount | 378359.52 |
| Total Medicare Standardized Payment Amount | 386247.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 3299 |
| Number Of Medicare Beneficiaries With Drug Services | 454 |
| Total Drug Submitted ChargeAmount | 73459.3 |
| Total Drug Medicare AllowedAmount | 66125.59 |
| Total Drug Medicare PaymentAmount | 57116.77 |
| Total Drug Medicare Standardized Payment Amount | 57116.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 8200 |
| Number Of Medicare Beneficiaries With Medical Services | 943 |
| Total Medical Submitted Charge Amount | 616214 |
| Total Medical Medicare Allowed Amount | 412913.94 |
| Total Medical Medicare Payment Amount | 321242.75 |
| Total Medical Medicare Standardized Payment Amount | 329130.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 486 |
| Number Of Beneficiaries Age 75 to 84 | 290 |
| Number Of Beneficiaries Age Greater 84 | 120 |
| Number Of Female Beneficiaries | 567 |
| Number Of Male Beneficiaries | 377 |
| Number Of Non Hispanic White Beneficiaries | 835 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 895 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.03 |