| National Provider Identifier [NPI]: | 1245678812 |
| Last Name Of The Provider | PRINZ |
| First Name Of The Provider | RACHEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 N 27TH ST |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 687014401 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 2815 |
| Number Of Medicare Beneficiaries | 514 |
| Total Submitted Charge Amount | 152593.5 |
| Total Medicare Allowed Amount | 78932.24 |
| Total Medicare Payment Amount | 57609.23 |
| Total Medicare Standardized Payment Amount | 71487.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 714 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 11542 |
| Total Drug Medicare AllowedAmount | 8156.24 |
| Total Drug Medicare PaymentAmount | 6413.14 |
| Total Drug Medicare Standardized Payment Amount | 6413.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 2101 |
| Number Of Medicare Beneficiaries With Medical Services | 514 |
| Total Medical Submitted Charge Amount | 141051.5 |
| Total Medical Medicare Allowed Amount | 70776 |
| Total Medical Medicare Payment Amount | 51196.09 |
| Total Medical Medicare Standardized Payment Amount | 65074.23 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 330 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 497 |
| 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 | 411 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.998 |