| National Provider Identifier [NPI]: | 1720152846 |
| Last Name Of The Provider | IZZO |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1035 CHARLEVOIX DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | GRAND LEDGE |
| Zip Code Of The Provider | 488372223 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 2293 |
| Number Of Medicare Beneficiaries | 550 |
| Total Submitted Charge Amount | 161477.18 |
| Total Medicare Allowed Amount | 139410.56 |
| Total Medicare Payment Amount | 94716.09 |
| Total Medicare Standardized Payment Amount | 104550.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 488 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 13302.76 |
| Total Drug Medicare AllowedAmount | 10457.13 |
| Total Drug Medicare PaymentAmount | 9851.3 |
| Total Drug Medicare Standardized Payment Amount | 9851.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1805 |
| Number Of Medicare Beneficiaries With Medical Services | 550 |
| Total Medical Submitted Charge Amount | 148174.42 |
| Total Medical Medicare Allowed Amount | 128953.43 |
| Total Medical Medicare Payment Amount | 84864.79 |
| Total Medical Medicare Standardized Payment Amount | 94698.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 284 |
| Number Of Male Beneficiaries | 266 |
| Number Of Non Hispanic White Beneficiaries | 531 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8366 |