| National Provider Identifier [NPI]: | 1699717637 |
| Last Name Of The Provider | PIETRAS |
| First Name Of The Provider | JEROME |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 570 EGG HARBOR RD |
| Street Address 2 Of The Provider | STE A-1 |
| City Of The Provider | SEWELL |
| Zip Code Of The Provider | 080802359 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 4167 |
| Number Of Medicare Beneficiaries | 980 |
| Total Submitted Charge Amount | 520092.73 |
| Total Medicare Allowed Amount | 295016.4 |
| Total Medicare Payment Amount | 216153.78 |
| Total Medicare Standardized Payment Amount | 204067.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 496 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 114993.75 |
| Total Drug Medicare AllowedAmount | 29961.16 |
| Total Drug Medicare PaymentAmount | 21513.65 |
| Total Drug Medicare Standardized Payment Amount | 21513.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 3671 |
| Number Of Medicare Beneficiaries With Medical Services | 980 |
| Total Medical Submitted Charge Amount | 405098.98 |
| Total Medical Medicare Allowed Amount | 265055.24 |
| Total Medical Medicare Payment Amount | 194640.13 |
| Total Medical Medicare Standardized Payment Amount | 182554.05 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 331 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 221 |
| Number Of Male Beneficiaries | 759 |
| Number Of Non Hispanic White Beneficiaries | 801 |
| Number Of Black or African American Beneficiaries | 129 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 789 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5725 |