| National Provider Identifier [NPI]: | 1306884192 |
| Last Name Of The Provider | WAXNER |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 233 E SHORE RD |
| Street Address 2 Of The Provider | #112 |
| City Of The Provider | GREAT NECK |
| Zip Code Of The Provider | 110232433 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 5858 |
| Number Of Medicare Beneficiaries | 1340 |
| Total Submitted Charge Amount | 1335869.11 |
| Total Medicare Allowed Amount | 533116.92 |
| Total Medicare Payment Amount | 409381.46 |
| Total Medicare Standardized Payment Amount | 358340.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1405 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 37529.53 |
| Total Drug Medicare AllowedAmount | 37312.78 |
| Total Drug Medicare PaymentAmount | 29532.44 |
| Total Drug Medicare Standardized Payment Amount | 29532.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 4453 |
| Number Of Medicare Beneficiaries With Medical Services | 1340 |
| Total Medical Submitted Charge Amount | 1298339.58 |
| Total Medical Medicare Allowed Amount | 495804.14 |
| Total Medical Medicare Payment Amount | 379849.02 |
| Total Medical Medicare Standardized Payment Amount | 328807.67 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 469 |
| Number Of Beneficiaries Age 75 to 84 | 455 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 629 |
| Number Of Male Beneficiaries | 711 |
| Number Of Non Hispanic White Beneficiaries | 1186 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1162 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1478 |