| National Provider Identifier [NPI]: | 1073523098 |
| Last Name Of The Provider | WITT |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 280 COMMERCIAL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 467831045 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 870 |
| Number Of Medicare Beneficiaries | 142 |
| Total Submitted Charge Amount | 78573 |
| Total Medicare Allowed Amount | 38094.92 |
| Total Medicare Payment Amount | 24703.57 |
| Total Medicare Standardized Payment Amount | 26372.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 2603 |
| Total Drug Medicare AllowedAmount | 972.15 |
| Total Drug Medicare PaymentAmount | 825.74 |
| Total Drug Medicare Standardized Payment Amount | 825.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 777 |
| Number Of Medicare Beneficiaries With Medical Services | 142 |
| Total Medical Submitted Charge Amount | 75970 |
| Total Medical Medicare Allowed Amount | 37122.77 |
| Total Medical Medicare Payment Amount | 23877.83 |
| Total Medical Medicare Standardized Payment Amount | 25546.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9445 |