| National Provider Identifier [NPI]: | 1811916950 |
| Last Name Of The Provider | WEITZEL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3161 HARBOR BLVD |
| Street Address 2 Of The Provider | UNIT D |
| City Of The Provider | PT CHARLOTTE |
| Zip Code Of The Provider | 339526754 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 8815 |
| Number Of Medicare Beneficiaries | 1258 |
| Total Submitted Charge Amount | 1592992.99 |
| Total Medicare Allowed Amount | 586051.26 |
| Total Medicare Payment Amount | 444124.89 |
| Total Medicare Standardized Payment Amount | 443765.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1975 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 155974.21 |
| Total Drug Medicare AllowedAmount | 94497.87 |
| Total Drug Medicare PaymentAmount | 73644.95 |
| Total Drug Medicare Standardized Payment Amount | 73644.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 6840 |
| Number Of Medicare Beneficiaries With Medical Services | 1258 |
| Total Medical Submitted Charge Amount | 1437018.78 |
| Total Medical Medicare Allowed Amount | 491553.39 |
| Total Medical Medicare Payment Amount | 370479.94 |
| Total Medical Medicare Standardized Payment Amount | 370120.23 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 550 |
| Number Of Beneficiaries Age 75 to 84 | 463 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 325 |
| Number Of Male Beneficiaries | 933 |
| Number Of Non Hispanic White Beneficiaries | 1169 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3606 |