| National Provider Identifier [NPI]: | 1740385426 |
| Last Name Of The Provider | LUTZ |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 NE MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977016051 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 1909 |
| Number Of Medicare Beneficiaries | 337 |
| Total Submitted Charge Amount | 337244.98 |
| Total Medicare Allowed Amount | 108985.36 |
| Total Medicare Payment Amount | 84819.56 |
| Total Medicare Standardized Payment Amount | 87690.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 4567.12 |
| Total Drug Medicare AllowedAmount | 2581.22 |
| Total Drug Medicare PaymentAmount | 2529.54 |
| Total Drug Medicare Standardized Payment Amount | 2529.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 1859 |
| Number Of Medicare Beneficiaries With Medical Services | 337 |
| Total Medical Submitted Charge Amount | 332677.86 |
| Total Medical Medicare Allowed Amount | 106404.14 |
| Total Medical Medicare Payment Amount | 82290.02 |
| Total Medical Medicare Standardized Payment Amount | 85161.19 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 306 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.0082 |