| National Provider Identifier [NPI]: | 1447248968 |
| Last Name Of The Provider | BOTZ |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1027 W GENESEE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRANKENMUTH |
| Zip Code Of The Provider | 487341302 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1346 |
| Number Of Medicare Beneficiaries | 272 |
| Total Submitted Charge Amount | 98774 |
| Total Medicare Allowed Amount | 67574.22 |
| Total Medicare Payment Amount | 44090.2 |
| Total Medicare Standardized Payment Amount | 47202.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 221 |
| Number Of Medicare Beneficiaries With Drug Services | 97 |
| Total Drug Submitted ChargeAmount | 4307 |
| Total Drug Medicare AllowedAmount | 2380.85 |
| Total Drug Medicare PaymentAmount | 2112.51 |
| Total Drug Medicare Standardized Payment Amount | 2112.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1125 |
| Number Of Medicare Beneficiaries With Medical Services | 272 |
| Total Medical Submitted Charge Amount | 94467 |
| Total Medical Medicare Allowed Amount | 65193.37 |
| Total Medical Medicare Payment Amount | 41977.69 |
| Total Medical Medicare Standardized Payment Amount | 45089.57 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0151 |