| National Provider Identifier [NPI]: | 1992793863 |
| Last Name Of The Provider | SEYBOLD |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 WESTHILL DR |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | WAUSAU |
| Zip Code Of The Provider | 544014707 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 1015 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 589890 |
| Total Medicare Allowed Amount | 119261.77 |
| Total Medicare Payment Amount | 90904.79 |
| Total Medicare Standardized Payment Amount | 96632.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 291 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 6194 |
| Total Drug Medicare AllowedAmount | 3538.79 |
| Total Drug Medicare PaymentAmount | 2774.38 |
| Total Drug Medicare Standardized Payment Amount | 2774.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 724 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 583696 |
| Total Medical Medicare Allowed Amount | 115722.98 |
| Total Medical Medicare Payment Amount | 88130.41 |
| Total Medical Medicare Standardized Payment Amount | 93858.02 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 83 |
| 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 | 202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0144 |