| National Provider Identifier [NPI]: | 1063641686 |
| Last Name Of The Provider | DREITZLER |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13934 N 59TH AVE STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 853064168 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1052 |
| Number Of Medicare Beneficiaries | 33 |
| Total Submitted Charge Amount | 98487.99 |
| Total Medicare Allowed Amount | 45767.44 |
| Total Medicare Payment Amount | 35043.16 |
| Total Medicare Standardized Payment Amount | 32244.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 144 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 4003 |
| Total Drug Medicare AllowedAmount | 1912.07 |
| Total Drug Medicare PaymentAmount | 1497.76 |
| Total Drug Medicare Standardized Payment Amount | 1497.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 908 |
| Number Of Medicare Beneficiaries With Medical Services | 33 |
| Total Medical Submitted Charge Amount | 94484.99 |
| Total Medical Medicare Allowed Amount | 43855.37 |
| Total Medical Medicare Payment Amount | 33545.4 |
| Total Medical Medicare Standardized Payment Amount | 30747.17 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 17 |
| Number Of Male Beneficiaries | 16 |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8493 |