| National Provider Identifier [NPI]: | 1033374525 |
| Last Name Of The Provider | PEVZNER |
| First Name Of The Provider | MILLIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 W FRANCIS ST STE 230 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH PLATTE |
| Zip Code Of The Provider | 691010614 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 2531 |
| Number Of Medicare Beneficiaries | 500 |
| Total Submitted Charge Amount | 771328 |
| Total Medicare Allowed Amount | 207815.8 |
| Total Medicare Payment Amount | 157157.57 |
| Total Medicare Standardized Payment Amount | 169226.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 116 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 22092 |
| Total Drug Medicare AllowedAmount | 12352.66 |
| Total Drug Medicare PaymentAmount | 9613.12 |
| Total Drug Medicare Standardized Payment Amount | 9613.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 2415 |
| Number Of Medicare Beneficiaries With Medical Services | 500 |
| Total Medical Submitted Charge Amount | 749236 |
| Total Medical Medicare Allowed Amount | 195463.14 |
| Total Medical Medicare Payment Amount | 147544.45 |
| Total Medical Medicare Standardized Payment Amount | 159613.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 219 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 486 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2755 |