| National Provider Identifier [NPI]: | 1033395348 |
| Last Name Of The Provider | STOLTZMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 39000 BOB HOPE DR |
| Street Address 2 Of The Provider | WRIGHT BLDG 409 |
| City Of The Provider | RANCHO MIRAGE |
| Zip Code Of The Provider | 922703221 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 505 |
| Number Of Medicare Beneficiaries | 135 |
| Total Submitted Charge Amount | 44934.48 |
| Total Medicare Allowed Amount | 34534.76 |
| Total Medicare Payment Amount | 25513.21 |
| Total Medicare Standardized Payment Amount | 25018.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1327 |
| Total Drug Medicare AllowedAmount | 809.42 |
| Total Drug Medicare PaymentAmount | 790.83 |
| Total Drug Medicare Standardized Payment Amount | 790.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 476 |
| Number Of Medicare Beneficiaries With Medical Services | 135 |
| Total Medical Submitted Charge Amount | 43607.48 |
| Total Medical Medicare Allowed Amount | 33725.34 |
| Total Medical Medicare Payment Amount | 24722.38 |
| Total Medical Medicare Standardized Payment Amount | 24227.72 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.972 |