| National Provider Identifier [NPI]: | 1326256827 |
| Last Name Of The Provider | LOTZ |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9800 SHELBYVILLE RD |
| Street Address 2 Of The Provider | SUITE #220 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402232992 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 8979 |
| Number Of Medicare Beneficiaries | 409 |
| Total Submitted Charge Amount | 148698.5 |
| Total Medicare Allowed Amount | 101188.96 |
| Total Medicare Payment Amount | 74257.85 |
| Total Medicare Standardized Payment Amount | 78773.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 740 |
| Total Drug Medicare AllowedAmount | 377.44 |
| Total Drug Medicare PaymentAmount | 369.9 |
| Total Drug Medicare Standardized Payment Amount | 369.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 8960 |
| Number Of Medicare Beneficiaries With Medical Services | 409 |
| Total Medical Submitted Charge Amount | 147958.5 |
| Total Medical Medicare Allowed Amount | 100811.52 |
| Total Medical Medicare Payment Amount | 73887.95 |
| Total Medical Medicare Standardized Payment Amount | 78403.66 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 291 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 380 |
| 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 | 350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 42 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8395 |