| National Provider Identifier [NPI]: | 1912980616 |
| Last Name Of The Provider | WIRTZ |
| First Name Of The Provider | CHRISTINA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1675 E MAIN ST |
| Street Address 2 Of The Provider | BOX 328 |
| City Of The Provider | KENT |
| Zip Code Of The Provider | 442405818 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 5489 |
| Number Of Medicare Beneficiaries | 2912 |
| Total Submitted Charge Amount | 432753 |
| Total Medicare Allowed Amount | 113263.77 |
| Total Medicare Payment Amount | 89296.5 |
| Total Medicare Standardized Payment Amount | 92001 |
| 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 | 173 |
| Number Of Medical Services | 5489 |
| Number Of Medicare Beneficiaries With Medical Services | 2912 |
| Total Medical Submitted Charge Amount | 432753 |
| Total Medical Medicare Allowed Amount | 113263.77 |
| Total Medical Medicare Payment Amount | 89296.5 |
| Total Medical Medicare Standardized Payment Amount | 92001 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 716 |
| Number Of Beneficiaries Age 65 to 74 | 911 |
| Number Of Beneficiaries Age 75 to 84 | 722 |
| Number Of Beneficiaries Age Greater 84 | 563 |
| Number Of Female Beneficiaries | 1765 |
| Number Of Male Beneficiaries | 1147 |
| Number Of Non Hispanic White Beneficiaries | 2389 |
| Number Of Black or African American Beneficiaries | 416 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1947 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 965 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9253 |