| National Provider Identifier [NPI]: | 1619974839 |
| Last Name Of The Provider | MARCIALES |
| First Name Of The Provider | WERTHER |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4401 CORTEZ RD W |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342103142 |
| 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 | 118 |
| Number Of Services | 7773 |
| Number Of Medicare Beneficiaries | 1045 |
| Total Submitted Charge Amount | 1490468.68 |
| Total Medicare Allowed Amount | 741243.69 |
| Total Medicare Payment Amount | 556552.38 |
| Total Medicare Standardized Payment Amount | 556787.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 155 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 3955.01 |
| Total Drug Medicare AllowedAmount | 1766.1 |
| Total Drug Medicare PaymentAmount | 1699.53 |
| Total Drug Medicare Standardized Payment Amount | 1699.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 7618 |
| Number Of Medicare Beneficiaries With Medical Services | 1045 |
| Total Medical Submitted Charge Amount | 1486513.67 |
| Total Medical Medicare Allowed Amount | 739477.59 |
| Total Medical Medicare Payment Amount | 554852.85 |
| Total Medical Medicare Standardized Payment Amount | 555088.26 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 273 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 374 |
| Number Of Female Beneficiaries | 596 |
| Number Of Male Beneficiaries | 449 |
| Number Of Non Hispanic White Beneficiaries | 972 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 872 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 173 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7432 |