| National Provider Identifier [NPI]: | 1447417076 |
| Last Name Of The Provider | HEITZLER |
| First Name Of The Provider | JOAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13417 US HIGHWAY 301 |
| Street Address 2 Of The Provider | STE. A |
| City Of The Provider | DADE CITY |
| Zip Code Of The Provider | 335255446 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 13411 |
| Number Of Medicare Beneficiaries | 37 |
| Total Submitted Charge Amount | 31268 |
| Total Medicare Allowed Amount | 18664.97 |
| Total Medicare Payment Amount | 13941.1 |
| Total Medicare Standardized Payment Amount | 15338.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 13241 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 14578 |
| Total Drug Medicare AllowedAmount | 9049.45 |
| Total Drug Medicare PaymentAmount | 7094.71 |
| Total Drug Medicare Standardized Payment Amount | 7094.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 170 |
| Number Of Medicare Beneficiaries With Medical Services | 37 |
| Total Medical Submitted Charge Amount | 16690 |
| Total Medical Medicare Allowed Amount | 9615.52 |
| Total Medical Medicare Payment Amount | 6846.39 |
| Total Medical Medicare Standardized Payment Amount | 8243.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 16 |
| Number Of Male Beneficiaries | 21 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.3245 |