| National Provider Identifier [NPI]: | 1447412945 |
| Last Name Of The Provider | WERTHEIMER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 726 GOODMAN RD E # B |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTHAVEN |
| Zip Code Of The Provider | 386719530 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1654 |
| Number Of Medicare Beneficiaries | 545 |
| Total Submitted Charge Amount | 351410.5 |
| Total Medicare Allowed Amount | 169018.32 |
| Total Medicare Payment Amount | 119388.78 |
| Total Medicare Standardized Payment Amount | 132581.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 4615.5 |
| Total Drug Medicare AllowedAmount | 4043.55 |
| Total Drug Medicare PaymentAmount | 3170.11 |
| Total Drug Medicare Standardized Payment Amount | 3170.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1588 |
| Number Of Medicare Beneficiaries With Medical Services | 545 |
| Total Medical Submitted Charge Amount | 346795 |
| Total Medical Medicare Allowed Amount | 164974.77 |
| Total Medical Medicare Payment Amount | 116218.67 |
| Total Medical Medicare Standardized Payment Amount | 129411.53 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 281 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 336 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 406 |
| 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 | 430 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2381 |