National Provider Identifier [NPI]: |
1063472249 |
Last Name Of The Provider |
PITTMAN |
First Name Of The Provider |
ERIC |
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 |
6644 E BAYWOOD AVE |
Street Address 2 Of The Provider |
BANNER BAYWOOD MEDICAL CENTER |
City Of The Provider |
MESA |
Zip Code Of The Provider |
85206 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1678 |
Number Of Medicare Beneficiaries |
815 |
Total Submitted Charge Amount |
399561 |
Total Medicare Allowed Amount |
201772.23 |
Total Medicare Payment Amount |
156787.48 |
Total Medicare Standardized Payment Amount |
158250.73 |
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 |
15 |
Number Of Medical Services |
1678 |
Number Of Medicare Beneficiaries With Medical Services |
815 |
Total Medical Submitted Charge Amount |
399561 |
Total Medical Medicare Allowed Amount |
201772.23 |
Total Medical Medicare Payment Amount |
156787.48 |
Total Medical Medicare Standardized Payment Amount |
158250.73 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
269 |
Number Of Beneficiaries Age 75 to 84 |
287 |
Number Of Beneficiaries Age Greater 84 |
160 |
Number Of Female Beneficiaries |
435 |
Number Of Male Beneficiaries |
380 |
Number Of Non Hispanic White Beneficiaries |
719 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
27 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
698 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.17 |