| National Provider Identifier [NPI]: | 1457349763 |
| Last Name Of The Provider | WAZNY |
| First Name Of The Provider | TOMASZ |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21205 OLEAN BLVD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | PORT CHARLOTTE |
| Zip Code Of The Provider | 339526756 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 144279 |
| Number Of Medicare Beneficiaries | 767 |
| Total Submitted Charge Amount | 1651341 |
| Total Medicare Allowed Amount | 1088439.52 |
| Total Medicare Payment Amount | 842302.29 |
| Total Medicare Standardized Payment Amount | 865850.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 127919 |
| Number Of Medicare Beneficiaries With Drug Services | 256 |
| Total Drug Submitted ChargeAmount | 444186.5 |
| Total Drug Medicare AllowedAmount | 155797.84 |
| Total Drug Medicare PaymentAmount | 121903.42 |
| Total Drug Medicare Standardized Payment Amount | 121903.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 16360 |
| Number Of Medicare Beneficiaries With Medical Services | 767 |
| Total Medical Submitted Charge Amount | 1207154.5 |
| Total Medical Medicare Allowed Amount | 932641.68 |
| Total Medical Medicare Payment Amount | 720398.87 |
| Total Medical Medicare Standardized Payment Amount | 743947.44 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 154 |
| Number Of Female Beneficiaries | 377 |
| Number Of Male Beneficiaries | 390 |
| Number Of Non Hispanic White Beneficiaries | 695 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 579 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.6423 |