| National Provider Identifier [NPI]: | 1124091772 |
| Last Name Of The Provider | HERZ |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 39000 BOB HOPE DR |
| Street Address 2 Of The Provider | KIEWIT BLDG. STE. 401 |
| City Of The Provider | RANCHO MIRAGE |
| Zip Code Of The Provider | 922703221 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1579 |
| Number Of Medicare Beneficiaries | 566 |
| Total Submitted Charge Amount | 269079.41 |
| Total Medicare Allowed Amount | 157163.9 |
| Total Medicare Payment Amount | 118048.45 |
| Total Medicare Standardized Payment Amount | 122879.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 25166.4 |
| Total Drug Medicare AllowedAmount | 10381.11 |
| Total Drug Medicare PaymentAmount | 7846.35 |
| Total Drug Medicare Standardized Payment Amount | 7846.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1505 |
| Number Of Medicare Beneficiaries With Medical Services | 566 |
| Total Medical Submitted Charge Amount | 243913.01 |
| Total Medical Medicare Allowed Amount | 146782.79 |
| Total Medical Medicare Payment Amount | 110202.1 |
| Total Medical Medicare Standardized Payment Amount | 115033.01 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 218 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 487 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 546 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.188 |