| National Provider Identifier [NPI]: | 1902831944 |
| Last Name Of The Provider | PITRE |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2230 NW PETTYGROVE |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 97210 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3020 |
| Number Of Medicare Beneficiaries | 328 |
| Total Submitted Charge Amount | 284019.82 |
| Total Medicare Allowed Amount | 124860.1 |
| Total Medicare Payment Amount | 92651.04 |
| Total Medicare Standardized Payment Amount | 92749.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1360 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 47620.82 |
| Total Drug Medicare AllowedAmount | 26339.01 |
| Total Drug Medicare PaymentAmount | 20649.01 |
| Total Drug Medicare Standardized Payment Amount | 20649.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1660 |
| Number Of Medicare Beneficiaries With Medical Services | 328 |
| Total Medical Submitted Charge Amount | 236399 |
| Total Medical Medicare Allowed Amount | 98521.09 |
| Total Medical Medicare Payment Amount | 72002.03 |
| Total Medical Medicare Standardized Payment Amount | 72100.75 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 275 |
| Number Of Non Hispanic White Beneficiaries | 315 |
| 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 | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1473 |