| National Provider Identifier [NPI]: | 1609072065 |
| Last Name Of The Provider | PITTA |
| First Name Of The Provider | SRIDEVI |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11937 US HWY 271 |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 75708 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 3227 |
| Number Of Medicare Beneficiaries | 1225 |
| Total Submitted Charge Amount | 555142.87 |
| Total Medicare Allowed Amount | 183066.94 |
| Total Medicare Payment Amount | 140228.35 |
| Total Medicare Standardized Payment Amount | 145230.39 |
| 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 | 99 |
| Number Of Medical Services | 3227 |
| Number Of Medicare Beneficiaries With Medical Services | 1225 |
| Total Medical Submitted Charge Amount | 555142.87 |
| Total Medical Medicare Allowed Amount | 183066.94 |
| Total Medical Medicare Payment Amount | 140228.35 |
| Total Medical Medicare Standardized Payment Amount | 145230.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 273 |
| Number Of Beneficiaries Age 65 to 74 | 460 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 651 |
| Number Of Male Beneficiaries | 574 |
| Number Of Non Hispanic White Beneficiaries | 947 |
| Number Of Black or African American Beneficiaries | 240 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 821 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 404 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8428 |