| National Provider Identifier [NPI]: | 1619105731 |
| Last Name Of The Provider | LOTZ |
| First Name Of The Provider | PAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | APN/CNS |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 902 NO. RIVERSIDE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ST. JOSEPH |
| Zip Code Of The Provider | 64507 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Clinical Nurse Specialist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 7530 |
| Number Of Medicare Beneficiaries | 257 |
| Total Submitted Charge Amount | 326953 |
| Total Medicare Allowed Amount | 146876.16 |
| Total Medicare Payment Amount | 115156.9 |
| Total Medicare Standardized Payment Amount | 121967.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 31 |
| Number Of Drug Services | 6655 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 252725 |
| Total Drug Medicare AllowedAmount | 107595.45 |
| Total Drug Medicare PaymentAmount | 84362.18 |
| Total Drug Medicare Standardized Payment Amount | 84362.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 875 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 74228 |
| Total Medical Medicare Allowed Amount | 39280.71 |
| Total Medical Medicare Payment Amount | 30794.72 |
| Total Medical Medicare Standardized Payment Amount | 37605.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 162 |
| Number Of Male Beneficiaries | 95 |
| Number Of Non Hispanic White Beneficiaries | 239 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.048 |