| National Provider Identifier [NPI]: | 1619935368 |
| Last Name Of The Provider | WITTELS |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | BRIGHAM & WOMENS HOSPITAL |
| Street Address 2 Of The Provider | 75 FRANCIS STREET |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 02115 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 645 |
| Number Of Medicare Beneficiaries | 577 |
| Total Submitted Charge Amount | 301725 |
| Total Medicare Allowed Amount | 88647.82 |
| Total Medicare Payment Amount | 68376.86 |
| Total Medicare Standardized Payment Amount | 66857.82 |
| 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 | 33 |
| Number Of Medical Services | 645 |
| Number Of Medicare Beneficiaries With Medical Services | 577 |
| Total Medical Submitted Charge Amount | 301725 |
| Total Medical Medicare Allowed Amount | 88647.82 |
| Total Medical Medicare Payment Amount | 68376.86 |
| Total Medical Medicare Standardized Payment Amount | 66857.82 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 352 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 382 |
| Number Of Black or African American Beneficiaries | 100 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 281 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0882 |