| National Provider Identifier [NPI]: | 1093739534 |
| Last Name Of The Provider | GEWIRTZ |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 MONTAUK HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST ISLIP |
| Zip Code Of The Provider | 117954927 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 904 |
| Number Of Medicare Beneficiaries | 532 |
| Total Submitted Charge Amount | 210428.74 |
| Total Medicare Allowed Amount | 84460.38 |
| Total Medicare Payment Amount | 63383.91 |
| Total Medicare Standardized Payment Amount | 55386.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1248.62 |
| Total Drug Medicare AllowedAmount | 344.72 |
| Total Drug Medicare PaymentAmount | 294.75 |
| Total Drug Medicare Standardized Payment Amount | 294.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 841 |
| Number Of Medicare Beneficiaries With Medical Services | 531 |
| Total Medical Submitted Charge Amount | 209180.12 |
| Total Medical Medicare Allowed Amount | 84115.66 |
| Total Medical Medicare Payment Amount | 63089.16 |
| Total Medical Medicare Standardized Payment Amount | 55091.8 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 364 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 482 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 443 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0445 |