| National Provider Identifier [NPI]: | 1952352221 |
| Last Name Of The Provider | LUTZ |
| First Name Of The Provider | LON |
| 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 | 17 EXCHANGE ST W STE 307 |
| Street Address 2 Of The Provider | STE 307 |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551021223 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1617 |
| Number Of Medicare Beneficiaries | 288 |
| Total Submitted Charge Amount | 797068 |
| Total Medicare Allowed Amount | 135971.32 |
| Total Medicare Payment Amount | 104507.89 |
| Total Medicare Standardized Payment Amount | 103130.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1617 |
| Number Of Medicare Beneficiaries With Medical Services | 288 |
| Total Medical Submitted Charge Amount | 797068 |
| Total Medical Medicare Allowed Amount | 135971.32 |
| Total Medical Medicare Payment Amount | 104507.89 |
| Total Medical Medicare Standardized Payment Amount | 103130.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 265 |
| 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 | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0996 |