| National Provider Identifier [NPI]: | 1669449104 |
| Last Name Of The Provider | GAITAN |
| First Name Of The Provider | PAUL |
| 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 | 19424 N R H JOHNSON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SUN CITY WEST |
| Zip Code Of The Provider | 85375 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1040 |
| Number Of Medicare Beneficiaries | 383 |
| Total Submitted Charge Amount | 649176.75 |
| Total Medicare Allowed Amount | 72855.68 |
| Total Medicare Payment Amount | 55866.41 |
| Total Medicare Standardized Payment Amount | 57363.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 452 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 47808.75 |
| Total Drug Medicare AllowedAmount | 176.55 |
| Total Drug Medicare PaymentAmount | 138.88 |
| Total Drug Medicare Standardized Payment Amount | 138.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 588 |
| Number Of Medicare Beneficiaries With Medical Services | 383 |
| Total Medical Submitted Charge Amount | 601368 |
| Total Medical Medicare Allowed Amount | 72679.13 |
| Total Medical Medicare Payment Amount | 55727.53 |
| Total Medical Medicare Standardized Payment Amount | 57224.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 219 |
| Number Of Non Hispanic White Beneficiaries | 349 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8036 |