| National Provider Identifier [NPI]: | 1225038706 |
| Last Name Of The Provider | LIPSCHUTZ |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13774 PLANTATION RD |
| Street Address 2 Of The Provider | UNIT 100 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339124461 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2701 |
| Number Of Medicare Beneficiaries | 510 |
| Total Submitted Charge Amount | 368455 |
| Total Medicare Allowed Amount | 166938.87 |
| Total Medicare Payment Amount | 119682.93 |
| Total Medicare Standardized Payment Amount | 115326.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 806 |
| Number Of Medicare Beneficiaries With Drug Services | 148 |
| Total Drug Submitted ChargeAmount | 31893 |
| Total Drug Medicare AllowedAmount | 15540.06 |
| Total Drug Medicare PaymentAmount | 13595.93 |
| Total Drug Medicare Standardized Payment Amount | 13595.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1895 |
| Number Of Medicare Beneficiaries With Medical Services | 510 |
| Total Medical Submitted Charge Amount | 336562 |
| Total Medical Medicare Allowed Amount | 151398.81 |
| Total Medical Medicare Payment Amount | 106087 |
| Total Medical Medicare Standardized Payment Amount | 101730.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 209 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | 479 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1316 |