| National Provider Identifier [NPI]: | 1760476667 |
| Last Name Of The Provider | ITKIN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 330 BORTHWICK AVE |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | PORTSMOUTH |
| Zip Code Of The Provider | 038014174 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 788 |
| Number Of Medicare Beneficiaries | 217 |
| Total Submitted Charge Amount | 142031 |
| Total Medicare Allowed Amount | 72150.61 |
| Total Medicare Payment Amount | 54805.72 |
| Total Medicare Standardized Payment Amount | 54367.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1977 |
| Total Drug Medicare AllowedAmount | 754.1 |
| Total Drug Medicare PaymentAmount | 739 |
| Total Drug Medicare Standardized Payment Amount | 739 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 770 |
| Number Of Medicare Beneficiaries With Medical Services | 217 |
| Total Medical Submitted Charge Amount | 140054 |
| Total Medical Medicare Allowed Amount | 71396.51 |
| Total Medical Medicare Payment Amount | 54066.72 |
| Total Medical Medicare Standardized Payment Amount | 53628.21 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 170 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.3605 |