National Provider Identifier [NPI]: |
1275699118 |
Last Name Of The Provider |
PITT |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17704 JEAN WAY |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
LAKE OSWEGO |
Zip Code Of The Provider |
970355497 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
3321 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
638686.29 |
Total Medicare Allowed Amount |
239167.69 |
Total Medicare Payment Amount |
177121.82 |
Total Medicare Standardized Payment Amount |
175355.38 |
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 |
65 |
Number Of Medical Services |
3321 |
Number Of Medicare Beneficiaries With Medical Services |
393 |
Total Medical Submitted Charge Amount |
638686.29 |
Total Medical Medicare Allowed Amount |
239167.69 |
Total Medical Medicare Payment Amount |
177121.82 |
Total Medical Medicare Standardized Payment Amount |
175355.38 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
226 |
Number Of Non Hispanic White Beneficiaries |
381 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8549 |