| National Provider Identifier [NPI]: | 1790758589 |
| Last Name Of The Provider | PLATZ |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9560 E 59TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462161010 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1577 |
| Number Of Medicare Beneficiaries | 367 |
| Total Submitted Charge Amount | 129641 |
| Total Medicare Allowed Amount | 89561.28 |
| Total Medicare Payment Amount | 59900.39 |
| Total Medicare Standardized Payment Amount | 64908.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 173 |
| Number Of Medicare Beneficiaries With Drug Services | 136 |
| Total Drug Submitted ChargeAmount | 10103 |
| Total Drug Medicare AllowedAmount | 6657.78 |
| Total Drug Medicare PaymentAmount | 6244.49 |
| Total Drug Medicare Standardized Payment Amount | 6244.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1404 |
| Number Of Medicare Beneficiaries With Medical Services | 366 |
| Total Medical Submitted Charge Amount | 119538 |
| Total Medical Medicare Allowed Amount | 82903.5 |
| Total Medical Medicare Payment Amount | 53655.9 |
| Total Medical Medicare Standardized Payment Amount | 58663.58 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 286 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1357 |