| National Provider Identifier [NPI]: | 1295901072 |
| Last Name Of The Provider | REETZ |
| First Name Of The Provider | HEIDI |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 623 S. MAIN ST. STE #1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOSCOW |
| Zip Code Of The Provider | 838432983 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 2540.5 |
| Number Of Medicare Beneficiaries | 253 |
| Total Submitted Charge Amount | 169979 |
| Total Medicare Allowed Amount | 89488.68 |
| Total Medicare Payment Amount | 70301.51 |
| Total Medicare Standardized Payment Amount | 75003.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 155.5 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 2901 |
| Total Drug Medicare AllowedAmount | 1771.94 |
| Total Drug Medicare PaymentAmount | 1657.89 |
| Total Drug Medicare Standardized Payment Amount | 1657.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 2385 |
| Number Of Medicare Beneficiaries With Medical Services | 253 |
| Total Medical Submitted Charge Amount | 167078 |
| Total Medical Medicare Allowed Amount | 87716.74 |
| Total Medical Medicare Payment Amount | 68643.62 |
| Total Medical Medicare Standardized Payment Amount | 73346.06 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 121 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 162 |
| Number Of Male Beneficiaries | 91 |
| 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 | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0717 |