| National Provider Identifier [NPI]: | 1538181870 |
| Last Name Of The Provider | WERTLIEB |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 48 ROUTE 25A |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | SMITHTOWN |
| Zip Code Of The Provider | 117871431 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 1244 |
| Number Of Medicare Beneficiaries | 210 |
| Total Submitted Charge Amount | 261211.6 |
| Total Medicare Allowed Amount | 107056.53 |
| Total Medicare Payment Amount | 81701.29 |
| Total Medicare Standardized Payment Amount | 72445.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 298 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 22264.33 |
| Total Drug Medicare AllowedAmount | 9883.34 |
| Total Drug Medicare PaymentAmount | 7553.34 |
| Total Drug Medicare Standardized Payment Amount | 7553.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 946 |
| Number Of Medicare Beneficiaries With Medical Services | 210 |
| Total Medical Submitted Charge Amount | 238947.27 |
| Total Medical Medicare Allowed Amount | 97173.19 |
| Total Medical Medicare Payment Amount | 74147.95 |
| Total Medical Medicare Standardized Payment Amount | 64891.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| Number Of Black or African American Beneficiaries | |
| 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 | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2472 |