| National Provider Identifier [NPI]: | 1750418463 |
| Last Name Of The Provider | WOOTEN |
| First Name Of The Provider | MARVIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3003 W GOOD HOPE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532092042 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 682 |
| Number Of Medicare Beneficiaries | 344 |
| Total Submitted Charge Amount | 258842 |
| Total Medicare Allowed Amount | 65226.04 |
| Total Medicare Payment Amount | 48434.96 |
| Total Medicare Standardized Payment Amount | 50702.53 |
| 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 | 24 |
| Number Of Medical Services | 682 |
| Number Of Medicare Beneficiaries With Medical Services | 344 |
| Total Medical Submitted Charge Amount | 258842 |
| Total Medical Medicare Allowed Amount | 65226.04 |
| Total Medical Medicare Payment Amount | 48434.96 |
| Total Medical Medicare Standardized Payment Amount | 50702.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 281 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 35 |
| Average HCC Risk Score Of Beneficiaries | 1.5373 |