| National Provider Identifier [NPI]: | 1134366818 |
| Last Name Of The Provider | WITKOSKY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 BEVERLY BLVD |
| Street Address 2 Of The Provider | TAPER M335 |
| City Of The Provider | WEST HOLLYWOOD |
| Zip Code Of The Provider | 900481804 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 9307 |
| Number Of Medicare Beneficiaries | 4118 |
| Total Submitted Charge Amount | 969362.67 |
| Total Medicare Allowed Amount | 138872.58 |
| Total Medicare Payment Amount | 107238.28 |
| Total Medicare Standardized Payment Amount | 102163.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3388 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 7564 |
| Total Drug Medicare AllowedAmount | 1082.72 |
| Total Drug Medicare PaymentAmount | 848.82 |
| Total Drug Medicare Standardized Payment Amount | 848.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 5919 |
| Number Of Medicare Beneficiaries With Medical Services | 4118 |
| Total Medical Submitted Charge Amount | 961798.67 |
| Total Medical Medicare Allowed Amount | 137789.86 |
| Total Medical Medicare Payment Amount | 106389.46 |
| Total Medical Medicare Standardized Payment Amount | 101314.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 654 |
| Number Of Beneficiaries Age 65 to 74 | 1291 |
| Number Of Beneficiaries Age 75 to 84 | 1165 |
| Number Of Beneficiaries Age Greater 84 | 1008 |
| Number Of Female Beneficiaries | 2224 |
| Number Of Male Beneficiaries | 1894 |
| Number Of Non Hispanic White Beneficiaries | 2757 |
| Number Of Black or African American Beneficiaries | 548 |
| Number Of AsianPacific Islander Beneficiaries | 285 |
| Number Of Hispanic Beneficiaries | 395 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 118 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1641 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.4537 |