| National Provider Identifier [NPI]: | 1225001860 |
| Last Name Of The Provider | BILTZ |
| First Name Of The Provider | JOHN |
| 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 | 401 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CORSICANA |
| Zip Code Of The Provider | 751102415 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 14999 |
| Number Of Medicare Beneficiaries | 2178 |
| Total Submitted Charge Amount | 1124171 |
| Total Medicare Allowed Amount | 645672.14 |
| Total Medicare Payment Amount | 447167.66 |
| Total Medicare Standardized Payment Amount | 462323.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 20932 |
| Total Drug Medicare AllowedAmount | 18850.71 |
| Total Drug Medicare PaymentAmount | 14499.23 |
| Total Drug Medicare Standardized Payment Amount | 14499.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 14915 |
| Number Of Medicare Beneficiaries With Medical Services | 2178 |
| Total Medical Submitted Charge Amount | 1103239 |
| Total Medical Medicare Allowed Amount | 626821.43 |
| Total Medical Medicare Payment Amount | 432668.43 |
| Total Medical Medicare Standardized Payment Amount | 447824.53 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 908 |
| Number Of Beneficiaries Age 75 to 84 | 836 |
| Number Of Beneficiaries Age Greater 84 | 374 |
| Number Of Female Beneficiaries | 1010 |
| Number Of Male Beneficiaries | 1168 |
| Number Of Non Hispanic White Beneficiaries | 2119 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2082 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9359 |