| National Provider Identifier [NPI]: | 1508813106 |
| Last Name Of The Provider | WHISENANT |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2315 8TH ST GRADE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 835017301 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 4884 |
| Number Of Medicare Beneficiaries | 1510 |
| Total Submitted Charge Amount | 951714 |
| Total Medicare Allowed Amount | 394643.52 |
| Total Medicare Payment Amount | 293415.37 |
| Total Medicare Standardized Payment Amount | 314190.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 269 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 18983 |
| Total Drug Medicare AllowedAmount | 9142.17 |
| Total Drug Medicare PaymentAmount | 7076.34 |
| Total Drug Medicare Standardized Payment Amount | 7076.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 4615 |
| Number Of Medicare Beneficiaries With Medical Services | 1510 |
| Total Medical Submitted Charge Amount | 932731 |
| Total Medical Medicare Allowed Amount | 385501.35 |
| Total Medical Medicare Payment Amount | 286339.03 |
| Total Medical Medicare Standardized Payment Amount | 307113.82 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 536 |
| Number Of Beneficiaries Age 75 to 84 | 603 |
| Number Of Beneficiaries Age Greater 84 | 252 |
| Number Of Female Beneficiaries | 682 |
| Number Of Male Beneficiaries | 828 |
| Number Of Non Hispanic White Beneficiaries | 1469 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1335 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2594 |