| National Provider Identifier [NPI]: | 1558366393 |
| Last Name Of The Provider | RETZIOS |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 S EDWIN C MOSES BLVD |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454173424 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2716 |
| Number Of Medicare Beneficiaries | 615 |
| Total Submitted Charge Amount | 230990 |
| Total Medicare Allowed Amount | 144833.2 |
| Total Medicare Payment Amount | 103530.7 |
| Total Medicare Standardized Payment Amount | 108938.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 840 |
| Total Drug Medicare AllowedAmount | 206.51 |
| Total Drug Medicare PaymentAmount | 149.02 |
| Total Drug Medicare Standardized Payment Amount | 149.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2548 |
| Number Of Medicare Beneficiaries With Medical Services | 615 |
| Total Medical Submitted Charge Amount | 230150 |
| Total Medical Medicare Allowed Amount | 144626.69 |
| Total Medical Medicare Payment Amount | 103381.68 |
| Total Medical Medicare Standardized Payment Amount | 108789.53 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 343 |
| Number Of Male Beneficiaries | 272 |
| Number Of Non Hispanic White Beneficiaries | 375 |
| Number Of Black or African American Beneficiaries | 225 |
| 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 | 457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 158 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6226 |