| National Provider Identifier [NPI]: | 1710191382 |
| Last Name Of The Provider | BORTZ |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 355 LENNON LN |
| Street Address 2 Of The Provider | SUITE 355 |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 945982418 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 9946 |
| Number Of Medicare Beneficiaries | 1442 |
| Total Submitted Charge Amount | 2607513.92 |
| Total Medicare Allowed Amount | 2040797.5 |
| Total Medicare Payment Amount | 1570152.75 |
| Total Medicare Standardized Payment Amount | 1293962.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 6070.19 |
| Total Drug Medicare AllowedAmount | 5344.87 |
| Total Drug Medicare PaymentAmount | 4189.02 |
| Total Drug Medicare Standardized Payment Amount | 4189.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 9869 |
| Number Of Medicare Beneficiaries With Medical Services | 1442 |
| Total Medical Submitted Charge Amount | 2601443.73 |
| Total Medical Medicare Allowed Amount | 2035452.63 |
| Total Medical Medicare Payment Amount | 1565963.73 |
| Total Medical Medicare Standardized Payment Amount | 1289773.24 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 572 |
| Number Of Beneficiaries Age 75 to 84 | 525 |
| Number Of Beneficiaries Age Greater 84 | 325 |
| Number Of Female Beneficiaries | 665 |
| Number Of Male Beneficiaries | 777 |
| Number Of Non Hispanic White Beneficiaries | 1403 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1422 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0386 |