| National Provider Identifier [NPI]: | 1871690743 |
| Last Name Of The Provider | STETZER |
| First Name Of The Provider | LEE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 391 MYRTLE AVENUE |
| Street Address 2 Of The Provider | SUITE 4A |
| City Of The Provider | ALBANY |
| Zip Code Of The Provider | 12208 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 548 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 36327 |
| Total Medicare Allowed Amount | 21164.86 |
| Total Medicare Payment Amount | 15907.44 |
| Total Medicare Standardized Payment Amount | 16795.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1736 |
| Total Drug Medicare AllowedAmount | 909.9 |
| Total Drug Medicare PaymentAmount | 889.12 |
| Total Drug Medicare Standardized Payment Amount | 889.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 524 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 34591 |
| Total Medical Medicare Allowed Amount | 20254.96 |
| Total Medical Medicare Payment Amount | 15018.32 |
| Total Medical Medicare Standardized Payment Amount | 15906.75 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 90 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1979 |