| National Provider Identifier [NPI]: | 1639172521 |
| Last Name Of The Provider | LOTZ |
| First Name Of The Provider | PRESTON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4960 W NEWBERRY RD |
| Street Address 2 Of The Provider | STE 280 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326072201 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 9865 |
| Number Of Medicare Beneficiaries | 4210 |
| Total Submitted Charge Amount | 1078842 |
| Total Medicare Allowed Amount | 346631.14 |
| Total Medicare Payment Amount | 264038.55 |
| Total Medicare Standardized Payment Amount | 271400.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4341 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 23038 |
| Total Drug Medicare AllowedAmount | 2833.83 |
| Total Drug Medicare PaymentAmount | 2209.65 |
| Total Drug Medicare Standardized Payment Amount | 2209.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 5524 |
| Number Of Medicare Beneficiaries With Medical Services | 4209 |
| Total Medical Submitted Charge Amount | 1055804 |
| Total Medical Medicare Allowed Amount | 343797.31 |
| Total Medical Medicare Payment Amount | 261828.9 |
| Total Medical Medicare Standardized Payment Amount | 269190.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 657 |
| Number Of Beneficiaries Age 65 to 74 | 1576 |
| Number Of Beneficiaries Age 75 to 84 | 1342 |
| Number Of Beneficiaries Age Greater 84 | 635 |
| Number Of Female Beneficiaries | 2602 |
| Number Of Male Beneficiaries | 1608 |
| Number Of Non Hispanic White Beneficiaries | 3664 |
| Number Of Black or African American Beneficiaries | 394 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1072 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5642 |