| National Provider Identifier [NPI]: | 1376785428 |
| Last Name Of The Provider | WHITTEN |
| First Name Of The Provider | IRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2014 WASHINGTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWTON |
| Zip Code Of The Provider | 024621607 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 2554 |
| Number Of Medicare Beneficiaries | 569 |
| Total Submitted Charge Amount | 889816 |
| Total Medicare Allowed Amount | 162329.3 |
| Total Medicare Payment Amount | 121386.65 |
| Total Medicare Standardized Payment Amount | 114643.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1063 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 10030 |
| Total Drug Medicare AllowedAmount | 1685.11 |
| Total Drug Medicare PaymentAmount | 1289.49 |
| Total Drug Medicare Standardized Payment Amount | 1289.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 1491 |
| Number Of Medicare Beneficiaries With Medical Services | 569 |
| Total Medical Submitted Charge Amount | 879786 |
| Total Medical Medicare Allowed Amount | 160644.19 |
| Total Medical Medicare Payment Amount | 120097.16 |
| Total Medical Medicare Standardized Payment Amount | 113354.13 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 300 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 517 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 295 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 274 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3042 |