National Provider Identifier [NPI]: |
1629131701 |
Last Name Of The Provider |
PITTS |
First Name Of The Provider |
WILFRID |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10 WINTHROP ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WORCESTER |
Zip Code Of The Provider |
01604 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1916 |
Number Of Medicare Beneficiaries |
188 |
Total Submitted Charge Amount |
198538 |
Total Medicare Allowed Amount |
153712.45 |
Total Medicare Payment Amount |
111105.11 |
Total Medicare Standardized Payment Amount |
109163.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
1150 |
Total Drug Medicare AllowedAmount |
293.02 |
Total Drug Medicare PaymentAmount |
253.35 |
Total Drug Medicare Standardized Payment Amount |
253.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1835 |
Number Of Medicare Beneficiaries With Medical Services |
188 |
Total Medical Submitted Charge Amount |
197388 |
Total Medical Medicare Allowed Amount |
153419.43 |
Total Medical Medicare Payment Amount |
110851.76 |
Total Medical Medicare Standardized Payment Amount |
108909.73 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
172 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
109 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4482 |