| National Provider Identifier [NPI]: | 1073608592 |
| Last Name Of The Provider | ETTINGER |
| First Name Of The Provider | ANDRE |
| 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 | 675 S ARROYO PKWY |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911053263 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1319 |
| Number Of Medicare Beneficiaries | 382 |
| Total Submitted Charge Amount | 183955 |
| Total Medicare Allowed Amount | 129642.06 |
| Total Medicare Payment Amount | 98938.85 |
| Total Medicare Standardized Payment Amount | 91348.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 4045 |
| Total Drug Medicare AllowedAmount | 3612.02 |
| Total Drug Medicare PaymentAmount | 3537.21 |
| Total Drug Medicare Standardized Payment Amount | 3537.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1263 |
| Number Of Medicare Beneficiaries With Medical Services | 382 |
| Total Medical Submitted Charge Amount | 179910 |
| Total Medical Medicare Allowed Amount | 126030.04 |
| Total Medical Medicare Payment Amount | 95401.64 |
| Total Medical Medicare Standardized Payment Amount | 87811.06 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 212 |
| Number Of Male Beneficiaries | 170 |
| Number Of Non Hispanic White Beneficiaries | 339 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.937 |