| National Provider Identifier [NPI]: | 1437104676 |
| Last Name Of The Provider | WASSERMAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 206 2ND ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342081042 |
| 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 | 227 |
| Number Of Services | 9780 |
| Number Of Medicare Beneficiaries | 4970 |
| Total Submitted Charge Amount | 687787 |
| Total Medicare Allowed Amount | 275998.98 |
| Total Medicare Payment Amount | 213054.59 |
| Total Medicare Standardized Payment Amount | 214562.23 |
| 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 | 227 |
| Number Of Medical Services | 9780 |
| Number Of Medicare Beneficiaries With Medical Services | 4970 |
| Total Medical Submitted Charge Amount | 687787 |
| Total Medical Medicare Allowed Amount | 275998.98 |
| Total Medical Medicare Payment Amount | 213054.59 |
| Total Medical Medicare Standardized Payment Amount | 214562.23 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 638 |
| Number Of Beneficiaries Age 65 to 74 | 1858 |
| Number Of Beneficiaries Age 75 to 84 | 1557 |
| Number Of Beneficiaries Age Greater 84 | 917 |
| Number Of Female Beneficiaries | 3059 |
| Number Of Male Beneficiaries | 1911 |
| Number Of Non Hispanic White Beneficiaries | 4374 |
| Number Of Black or African American Beneficiaries | 330 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 181 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 60 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3954 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1016 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6426 |