| National Provider Identifier [NPI]: | 1073545851 |
| Last Name Of The Provider | ELZE |
| First Name Of The Provider | MAREN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1850 BEAM AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MAPLEWOOD |
| Zip Code Of The Provider | 551091162 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 763 |
| Number Of Medicare Beneficiaries | 280 |
| Total Submitted Charge Amount | 168344 |
| Total Medicare Allowed Amount | 54281.28 |
| Total Medicare Payment Amount | 39711.35 |
| Total Medicare Standardized Payment Amount | 41069.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 89 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1420 |
| Total Drug Medicare AllowedAmount | 544.51 |
| Total Drug Medicare PaymentAmount | 430.77 |
| Total Drug Medicare Standardized Payment Amount | 430.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 674 |
| Number Of Medicare Beneficiaries With Medical Services | 280 |
| Total Medical Submitted Charge Amount | 166924 |
| Total Medical Medicare Allowed Amount | 53736.77 |
| Total Medical Medicare Payment Amount | 39280.58 |
| Total Medical Medicare Standardized Payment Amount | 40638.31 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 248 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5961 |