| National Provider Identifier [NPI]: | 1528015849 |
| Last Name Of The Provider | MITU |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | F.N.P., P.A.-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 306 E PACIFIC COAST HWY |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | LONG BEACH |
| Zip Code Of The Provider | 908066259 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 1455 |
| Number Of Medicare Beneficiaries | 402 |
| Total Submitted Charge Amount | 229400 |
| Total Medicare Allowed Amount | 82626.71 |
| Total Medicare Payment Amount | 58035.77 |
| Total Medicare Standardized Payment Amount | 60833.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 13600 |
| Total Drug Medicare AllowedAmount | 4423.19 |
| Total Drug Medicare PaymentAmount | 4334.5 |
| Total Drug Medicare Standardized Payment Amount | 4334.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 1296 |
| Number Of Medicare Beneficiaries With Medical Services | 402 |
| Total Medical Submitted Charge Amount | 215800 |
| Total Medical Medicare Allowed Amount | 78203.52 |
| Total Medical Medicare Payment Amount | 53701.27 |
| Total Medical Medicare Standardized Payment Amount | 56499.24 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 259 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 309 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 14 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 388 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4758 |