| National Provider Identifier [NPI]: | 1104812007 |
| Last Name Of The Provider | PIETRAS |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 629D LOWTHER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISBERRY |
| Zip Code Of The Provider | 173399527 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 4589 |
| Number Of Medicare Beneficiaries | 3290 |
| Total Submitted Charge Amount | 544384 |
| Total Medicare Allowed Amount | 141626.73 |
| Total Medicare Payment Amount | 109832.82 |
| Total Medicare Standardized Payment Amount | 113557.29 |
| 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 | 180 |
| Number Of Medical Services | 4589 |
| Number Of Medicare Beneficiaries With Medical Services | 3290 |
| Total Medical Submitted Charge Amount | 544384 |
| Total Medical Medicare Allowed Amount | 141626.73 |
| Total Medical Medicare Payment Amount | 109832.82 |
| Total Medical Medicare Standardized Payment Amount | 113557.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 421 |
| Number Of Beneficiaries Age 65 to 74 | 1172 |
| Number Of Beneficiaries Age 75 to 84 | 1031 |
| Number Of Beneficiaries Age Greater 84 | 666 |
| Number Of Female Beneficiaries | 2102 |
| Number Of Male Beneficiaries | 1188 |
| Number Of Non Hispanic White Beneficiaries | 3010 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2769 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 521 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5352 |