| National Provider Identifier [NPI]: | 1518980473 |
| Last Name Of The Provider | TITKO |
| First Name Of The Provider | YELENA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1450 CHAPEL ST |
| Street Address 2 Of The Provider | HOSPITAL OF SAINT RAPHAEL |
| City Of The Provider | NEW HAVEN |
| Zip Code Of The Provider | 065114405 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 241 |
| Number Of Medicare Beneficiaries | 87 |
| Total Submitted Charge Amount | 27053 |
| Total Medicare Allowed Amount | 15453.11 |
| Total Medicare Payment Amount | 12150.77 |
| Total Medicare Standardized Payment Amount | 11492.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1434 |
| Total Drug Medicare AllowedAmount | 645.76 |
| Total Drug Medicare PaymentAmount | 632.89 |
| Total Drug Medicare Standardized Payment Amount | 632.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 212 |
| Number Of Medicare Beneficiaries With Medical Services | 87 |
| Total Medical Submitted Charge Amount | 25619 |
| Total Medical Medicare Allowed Amount | 14807.35 |
| Total Medical Medicare Payment Amount | 11517.88 |
| Total Medical Medicare Standardized Payment Amount | 10859.55 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 17 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 33 |
| Number Of Non Hispanic White Beneficiaries | 45 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 11 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7033 |