| National Provider Identifier [NPI]: | 1073582649 |
| Last Name Of The Provider | BLATZ |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 221 E HACIENDA AVE STE C |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMPBELL |
| Zip Code Of The Provider | 950086625 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 848 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 627346.24 |
| Total Medicare Allowed Amount | 166944.92 |
| Total Medicare Payment Amount | 126163.38 |
| Total Medicare Standardized Payment Amount | 112829.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 540 |
| Total Drug Medicare AllowedAmount | 151.68 |
| Total Drug Medicare PaymentAmount | 118.93 |
| Total Drug Medicare Standardized Payment Amount | 118.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 821 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 626806.24 |
| Total Medical Medicare Allowed Amount | 166793.24 |
| Total Medical Medicare Payment Amount | 126044.45 |
| Total Medical Medicare Standardized Payment Amount | 112710.48 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 187 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7641 |