| National Provider Identifier [NPI]: | 1710193016 |
| Last Name Of The Provider | PITEA |
| First Name Of The Provider | TEODOR |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14416 W MEEKER BLVD BLDG C |
| Street Address 2 Of The Provider | |
| City Of The Provider | SUN CITY WEST |
| Zip Code Of The Provider | 853755284 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 1868 |
| Number Of Medicare Beneficiaries | 552 |
| Total Submitted Charge Amount | 898962 |
| Total Medicare Allowed Amount | 292695.36 |
| Total Medicare Payment Amount | 226921.65 |
| Total Medicare Standardized Payment Amount | 231987.29 |
| 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 | 93 |
| Number Of Medical Services | 1868 |
| Number Of Medicare Beneficiaries With Medical Services | 552 |
| Total Medical Submitted Charge Amount | 898962 |
| Total Medical Medicare Allowed Amount | 292695.36 |
| Total Medical Medicare Payment Amount | 226921.65 |
| Total Medical Medicare Standardized Payment Amount | 231987.29 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 296 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 505 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 514 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.76 |