National Provider Identifier [NPI]: |
1104096239 |
Last Name Of The Provider |
PITARAS |
First Name Of The Provider |
ELIAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1029 MEDICAL CENTER CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAYFIELD |
Zip Code Of The Provider |
420661189 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
6419 |
Number Of Medicare Beneficiaries |
893 |
Total Submitted Charge Amount |
1644462 |
Total Medicare Allowed Amount |
668691.37 |
Total Medicare Payment Amount |
508113.13 |
Total Medicare Standardized Payment Amount |
512072.18 |
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 |
25 |
Number Of Medical Services |
6419 |
Number Of Medicare Beneficiaries With Medical Services |
893 |
Total Medical Submitted Charge Amount |
1644462 |
Total Medical Medicare Allowed Amount |
668691.37 |
Total Medical Medicare Payment Amount |
508113.13 |
Total Medical Medicare Standardized Payment Amount |
512072.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
188 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
251 |
Number Of Beneficiaries Age Greater 84 |
172 |
Number Of Female Beneficiaries |
514 |
Number Of Male Beneficiaries |
379 |
Number Of Non Hispanic White Beneficiaries |
801 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
515 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
378 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.2498 |