| National Provider Identifier [NPI]: | 1215989645 |
| Last Name Of The Provider | NOWATZKE |
| First Name Of The Provider | TIM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.A.-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 383 S 300 E |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST GEORGE |
| Zip Code Of The Provider | 847703620 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 3545 |
| Number Of Medicare Beneficiaries | 928 |
| Total Submitted Charge Amount | 279676 |
| Total Medicare Allowed Amount | 146697.15 |
| Total Medicare Payment Amount | 99774.36 |
| Total Medicare Standardized Payment Amount | 119324.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 4324 |
| Total Drug Medicare AllowedAmount | 3787.36 |
| Total Drug Medicare PaymentAmount | 2875.31 |
| Total Drug Medicare Standardized Payment Amount | 2875.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 3474 |
| Number Of Medicare Beneficiaries With Medical Services | 928 |
| Total Medical Submitted Charge Amount | 275352 |
| Total Medical Medicare Allowed Amount | 142909.79 |
| Total Medical Medicare Payment Amount | 96899.05 |
| Total Medical Medicare Standardized Payment Amount | 116449.05 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 453 |
| Number Of Beneficiaries Age 75 to 84 | 330 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 504 |
| Number Of Non Hispanic White Beneficiaries | 905 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 903 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9804 |