| National Provider Identifier [NPI]: | 1396764460 |
| Last Name Of The Provider | WITFILL |
| First Name Of The Provider | KRISTIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8220 US19 NORTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT RICHEY |
| Zip Code Of The Provider | 34668 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 7310 |
| Number Of Medicare Beneficiaries | 944 |
| Total Submitted Charge Amount | 1448746.48 |
| Total Medicare Allowed Amount | 635998.41 |
| Total Medicare Payment Amount | 480596.68 |
| Total Medicare Standardized Payment Amount | 468801.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 8536.48 |
| Total Drug Medicare AllowedAmount | 7666.49 |
| Total Drug Medicare PaymentAmount | 5945.65 |
| Total Drug Medicare Standardized Payment Amount | 5945.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 7247 |
| Number Of Medicare Beneficiaries With Medical Services | 944 |
| Total Medical Submitted Charge Amount | 1440210 |
| Total Medical Medicare Allowed Amount | 628331.92 |
| Total Medical Medicare Payment Amount | 474651.03 |
| Total Medical Medicare Standardized Payment Amount | 462855.6 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 490 |
| Number Of Beneficiaries Age 75 to 84 | 271 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 560 |
| Number Of Male Beneficiaries | 384 |
| Number Of Non Hispanic White Beneficiaries | 907 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 878 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0265 |