| National Provider Identifier [NPI]: | 1932154671 |
| Last Name Of The Provider | WILLSTEIN |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2360 MULLAN RD |
| Street Address 2 Of The Provider | STE C |
| City Of The Provider | MISSOULA |
| Zip Code Of The Provider | 598081811 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 1715 |
| Number Of Medicare Beneficiaries | 441 |
| Total Submitted Charge Amount | 507229.5 |
| Total Medicare Allowed Amount | 215838.78 |
| Total Medicare Payment Amount | 163747.59 |
| Total Medicare Standardized Payment Amount | 162917.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 571 |
| Number Of Medicare Beneficiaries With Drug Services | 143 |
| Total Drug Submitted ChargeAmount | 9831 |
| Total Drug Medicare AllowedAmount | 5475.07 |
| Total Drug Medicare PaymentAmount | 4256.1 |
| Total Drug Medicare Standardized Payment Amount | 4256.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 1144 |
| Number Of Medicare Beneficiaries With Medical Services | 441 |
| Total Medical Submitted Charge Amount | 497398.5 |
| Total Medical Medicare Allowed Amount | 210363.71 |
| Total Medical Medicare Payment Amount | 159491.49 |
| Total Medical Medicare Standardized Payment Amount | 158661.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 134 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 422 |
| 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 | 398 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0057 |