| National Provider Identifier [NPI]: | 1184797110 |
| Last Name Of The Provider | HARTZELL |
| First Name Of The Provider | TRISTAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 N 27TH ST |
| Street Address 2 Of The Provider | SUITE 2 |
| 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 | Hand Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 286 |
| Number Of Services | 1917 |
| Number Of Medicare Beneficiaries | 390 |
| Total Submitted Charge Amount | 1208162 |
| Total Medicare Allowed Amount | 353260.64 |
| Total Medicare Payment Amount | 272419.86 |
| Total Medicare Standardized Payment Amount | 295122.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 871 |
| Total Drug Medicare AllowedAmount | 119.61 |
| Total Drug Medicare PaymentAmount | 90.95 |
| Total Drug Medicare Standardized Payment Amount | 90.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 285 |
| Number Of Medical Services | 1850 |
| Number Of Medicare Beneficiaries With Medical Services | 390 |
| Total Medical Submitted Charge Amount | 1207291 |
| Total Medical Medicare Allowed Amount | 353141.03 |
| Total Medical Medicare Payment Amount | 272328.91 |
| Total Medical Medicare Standardized Payment Amount | 295031.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | 379 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 322 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1162 |