| National Provider Identifier [NPI]: | 1376599258 |
| Last Name Of The Provider | WIENER |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 MEADOWS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOCA RATON |
| Zip Code Of The Provider | 334862304 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 19427 |
| Number Of Medicare Beneficiaries | 5923 |
| Total Submitted Charge Amount | 1728343.6 |
| Total Medicare Allowed Amount | 780425.28 |
| Total Medicare Payment Amount | 599780.51 |
| Total Medicare Standardized Payment Amount | 591062.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 9331 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 6117.6 |
| Total Drug Medicare AllowedAmount | 3145.68 |
| Total Drug Medicare PaymentAmount | 2458.17 |
| Total Drug Medicare Standardized Payment Amount | 2458.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 204 |
| Number Of Medical Services | 10096 |
| Number Of Medicare Beneficiaries With Medical Services | 5919 |
| Total Medical Submitted Charge Amount | 1722226 |
| Total Medical Medicare Allowed Amount | 777279.6 |
| Total Medical Medicare Payment Amount | 597322.34 |
| Total Medical Medicare Standardized Payment Amount | 588604.19 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 211 |
| Number Of Beneficiaries Age 65 to 74 | 1495 |
| Number Of Beneficiaries Age 75 to 84 | 2165 |
| Number Of Beneficiaries Age Greater 84 | 2052 |
| Number Of Female Beneficiaries | 3184 |
| Number Of Male Beneficiaries | 2739 |
| Number Of Non Hispanic White Beneficiaries | 5606 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 137 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 68 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5505 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 418 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8857 |