| National Provider Identifier [NPI]: | 1124027362 |
| Last Name Of The Provider | ROTH |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 446 TAMIAMI TRL S |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342852625 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 9371 |
| Number Of Medicare Beneficiaries | 4216 |
| Total Submitted Charge Amount | 670065 |
| Total Medicare Allowed Amount | 437917.75 |
| Total Medicare Payment Amount | 341313.23 |
| Total Medicare Standardized Payment Amount | 278404.03 |
| 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 | 34 |
| Number Of Medical Services | 9371 |
| Number Of Medicare Beneficiaries With Medical Services | 4216 |
| Total Medical Submitted Charge Amount | 670065 |
| Total Medical Medicare Allowed Amount | 437917.75 |
| Total Medical Medicare Payment Amount | 341313.23 |
| Total Medical Medicare Standardized Payment Amount | 278404.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 236 |
| Number Of Beneficiaries Age 65 to 74 | 1872 |
| Number Of Beneficiaries Age 75 to 84 | 1465 |
| Number Of Beneficiaries Age Greater 84 | 643 |
| Number Of Female Beneficiaries | 2563 |
| Number Of Male Beneficiaries | 1653 |
| Number Of Non Hispanic White Beneficiaries | 4047 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3972 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 244 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1271 |