| National Provider Identifier [NPI]: | 1700881513 |
| Last Name Of The Provider | STOLTZ |
| First Name Of The Provider | KURT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 413 GERMANTOWN PIKE |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | LAFAYETTE HILL |
| Zip Code Of The Provider | 194441816 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 4512 |
| Number Of Medicare Beneficiaries | 1903 |
| Total Submitted Charge Amount | 584924 |
| Total Medicare Allowed Amount | 528596.45 |
| Total Medicare Payment Amount | 413321.55 |
| Total Medicare Standardized Payment Amount | 387273.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 4512 |
| Number Of Medicare Beneficiaries With Medical Services | 1903 |
| Total Medical Submitted Charge Amount | 584924 |
| Total Medical Medicare Allowed Amount | 528596.45 |
| Total Medical Medicare Payment Amount | 413321.55 |
| Total Medical Medicare Standardized Payment Amount | 387273.71 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 136 |
| Number Of Beneficiaries Age 65 to 74 | 339 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 905 |
| Number Of Female Beneficiaries | 1290 |
| Number Of Male Beneficiaries | 613 |
| Number Of Non Hispanic White Beneficiaries | 1179 |
| Number Of Black or African American Beneficiaries | 607 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1749 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.3523 |