| National Provider Identifier [NPI]: | 1770574097 |
| Last Name Of The Provider | PEITZ |
| First Name Of The Provider | THOMAS |
| 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 | 2333 BUCHANAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941151925 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 701 |
| Number Of Medicare Beneficiaries | 432 |
| Total Submitted Charge Amount | 280893 |
| Total Medicare Allowed Amount | 82391.44 |
| Total Medicare Payment Amount | 64267.11 |
| Total Medicare Standardized Payment Amount | 58893.07 |
| 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 | 31 |
| Number Of Medical Services | 701 |
| Number Of Medicare Beneficiaries With Medical Services | 432 |
| Total Medical Submitted Charge Amount | 280893 |
| Total Medical Medicare Allowed Amount | 82391.44 |
| Total Medical Medicare Payment Amount | 64267.11 |
| Total Medical Medicare Standardized Payment Amount | 58893.07 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 262 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.0685 |