| National Provider Identifier [NPI]: | 1598865636 |
| Last Name Of The Provider | GAITAN |
| First Name Of The Provider | DANIEL |
| 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 | 969 MASON ROAD |
| Street Address 2 Of The Provider | STE 145 |
| City Of The Provider | CREVE COEUR |
| Zip Code Of The Provider | 63141 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 4427 |
| Number Of Medicare Beneficiaries | 312 |
| Total Submitted Charge Amount | 262363 |
| Total Medicare Allowed Amount | 150441.6 |
| Total Medicare Payment Amount | 117339.49 |
| Total Medicare Standardized Payment Amount | 120100.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 591 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 10528 |
| Total Drug Medicare AllowedAmount | 8575.13 |
| Total Drug Medicare PaymentAmount | 7006.01 |
| Total Drug Medicare Standardized Payment Amount | 7006.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 3836 |
| Number Of Medicare Beneficiaries With Medical Services | 312 |
| Total Medical Submitted Charge Amount | 251835 |
| Total Medical Medicare Allowed Amount | 141866.47 |
| Total Medical Medicare Payment Amount | 110333.48 |
| Total Medical Medicare Standardized Payment Amount | 113094.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 272 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2535 |