| National Provider Identifier [NPI]: | 1730114356 |
| Last Name Of The Provider | WITTMAIER |
| First Name Of The Provider | DEBRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | RN, PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2650 EXECUTIVE PARK NW |
| Street Address 2 Of The Provider | SUITE 5 |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 373122746 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 736 |
| Number Of Medicare Beneficiaries | 110 |
| Total Submitted Charge Amount | 41418 |
| Total Medicare Allowed Amount | 25763.35 |
| Total Medicare Payment Amount | 20475.17 |
| Total Medicare Standardized Payment Amount | 25725.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 152 |
| Total Drug Medicare AllowedAmount | 44.59 |
| Total Drug Medicare PaymentAmount | 41.76 |
| Total Drug Medicare Standardized Payment Amount | 41.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 706 |
| Number Of Medicare Beneficiaries With Medical Services | 110 |
| Total Medical Submitted Charge Amount | 41266 |
| Total Medical Medicare Allowed Amount | 25718.76 |
| Total Medical Medicare Payment Amount | 20433.41 |
| Total Medical Medicare Standardized Payment Amount | 25683.84 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 14 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 38 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 19 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4029 |