National Provider Identifier [NPI]: |
1477621662 |
Last Name Of The Provider |
PITTS |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
269 SW 19TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ONTARIO |
Zip Code Of The Provider |
979141972 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1264 |
Number Of Medicare Beneficiaries |
562 |
Total Submitted Charge Amount |
197890.37 |
Total Medicare Allowed Amount |
160107.66 |
Total Medicare Payment Amount |
111449.57 |
Total Medicare Standardized Payment Amount |
122743.43 |
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 |
19 |
Number Of Medical Services |
1264 |
Number Of Medicare Beneficiaries With Medical Services |
562 |
Total Medical Submitted Charge Amount |
197890.37 |
Total Medical Medicare Allowed Amount |
160107.66 |
Total Medical Medicare Payment Amount |
111449.57 |
Total Medical Medicare Standardized Payment Amount |
122743.43 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
329 |
Number Of Male Beneficiaries |
233 |
Number Of Non Hispanic White Beneficiaries |
513 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0514 |