| National Provider Identifier [NPI]: | 1104012566 |
| Last Name Of The Provider | WITTERSHEIM |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3615 HOSPITAL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PASCAGOULA |
| Zip Code Of The Provider | 395814112 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 3273 |
| Number Of Medicare Beneficiaries | 403 |
| Total Submitted Charge Amount | 765621 |
| Total Medicare Allowed Amount | 232079.58 |
| Total Medicare Payment Amount | 173682.62 |
| Total Medicare Standardized Payment Amount | 191716.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 945 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 85713 |
| Total Drug Medicare AllowedAmount | 36169.76 |
| Total Drug Medicare PaymentAmount | 28237.96 |
| Total Drug Medicare Standardized Payment Amount | 28237.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 2328 |
| Number Of Medicare Beneficiaries With Medical Services | 403 |
| Total Medical Submitted Charge Amount | 679908 |
| Total Medical Medicare Allowed Amount | 195909.82 |
| Total Medical Medicare Payment Amount | 145444.66 |
| Total Medical Medicare Standardized Payment Amount | 163478.1 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 267 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 334 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 276 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2966 |