| National Provider Identifier [NPI]: | 1801025432 |
| Last Name Of The Provider | WITTGENS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1540 LAKE LANSING RD |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | LANSING |
| Zip Code Of The Provider | 489123756 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 554 |
| Number Of Medicare Beneficiaries | 167 |
| Total Submitted Charge Amount | 48602 |
| Total Medicare Allowed Amount | 33893.22 |
| Total Medicare Payment Amount | 23143.37 |
| Total Medicare Standardized Payment Amount | 24266.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1575 |
| Total Drug Medicare AllowedAmount | 1243.1 |
| Total Drug Medicare PaymentAmount | 1044.15 |
| Total Drug Medicare Standardized Payment Amount | 1044.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 473 |
| Number Of Medicare Beneficiaries With Medical Services | 167 |
| Total Medical Submitted Charge Amount | 47027 |
| Total Medical Medicare Allowed Amount | 32650.12 |
| Total Medical Medicare Payment Amount | 22099.22 |
| Total Medical Medicare Standardized Payment Amount | 23222.36 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 155 |
| 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 | 146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8339 |