| National Provider Identifier [NPI]: | 1912901851 | 
| Last Name Of The Provider | BEITZEL | 
| First Name Of The Provider | JAMES | 
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD | 
| Gender Of The Provider | M | 
| Entity Type Of The Provider | I | 
| Street Address 1 Of The Provider | 1270 E STATE ROAD 205 | 
| Street Address 2 Of The Provider | SUITE 210 | 
| City Of The Provider | COLUMBIA CITY | 
| Zip Code Of The Provider | 467259499 | 
| State Code Of The Provider | IN | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | Internal Medicine | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 25 | 
| Number Of Services | 1595 | 
| Number Of Medicare Beneficiaries | 434 | 
| Total Submitted Charge Amount | 153820 | 
| Total Medicare Allowed Amount | 83394.23 | 
| Total Medicare Payment Amount | 53601.88 | 
| Total Medicare Standardized Payment Amount | 58084.82 | 
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 | 
| Number Of Drug Services | 246 | 
| Number Of Medicare Beneficiaries With Drug Services | 113 | 
| Total Drug Submitted ChargeAmount | 13826 | 
| Total Drug Medicare AllowedAmount | 4144.98 | 
| Total Drug Medicare PaymentAmount | 3987.17 | 
| Total Drug Medicare Standardized Payment Amount | 3987.17 | 
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 | 
| Number Of Medical Services | 1349 | 
| Number Of Medicare Beneficiaries With Medical Services | 434 | 
| Total Medical Submitted Charge Amount | 139994 | 
| Total Medical Medicare Allowed Amount | 79249.25 | 
| Total Medical Medicare Payment Amount | 49614.71 | 
| Total Medical Medicare Standardized Payment Amount | 54097.65 | 
| Average Age Of Beneficiaries | 68 | 
| Number Of Beneficiaries Age Less65 | 124 | 
| Number Of Beneficiaries Age 65 to 74 | 168 | 
| Number Of Beneficiaries Age 75 to 84 | 82 | 
| Number Of Beneficiaries Age Greater 84 | 60 | 
| Number Of Female Beneficiaries | 245 | 
| Number Of Male Beneficiaries | 189 | 
| Number Of Non Hispanic White Beneficiaries | 419 | 
| 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 | 315 | 
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 | 
| Percent Of With Atrial Fibrillation | 8 | 
| Percent Of With Alzheimers Disease or Dementia | 8 | 
| Percent Of With Asthma | 6 | 
| Percent Of With Cancer | 6 | 
| Percent Of With Heart Failure | 9 | 
| Percent Of With Chronic Kidney Disease | 13 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 | 
| Percent Of With Depression | 23 | 
| Percent Of With Diabetes | 28 | 
| Percent Of With Hyperlipidemia | 38 | 
| Percent Of With Hypertension | 53 | 
| Percent Of With Ischemic Heart Disease | 25 | 
| Percent Of With Osteoporosis | 4 | 
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 | 
| Percent Of With Stroke | 3 | 
| Average HCC Risk Score Of Beneficiaries | 0.913 |