| National Provider Identifier [NPI]: | 1780689992 |
| Last Name Of The Provider | PIETSCH |
| First Name Of The Provider | DARRELL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6600 FISH POND RD STE 202A |
| Street Address 2 Of The Provider | |
| City Of The Provider | WACO |
| Zip Code Of The Provider | 767102582 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 3593 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 265799.01 |
| Total Medicare Allowed Amount | 165500.09 |
| Total Medicare Payment Amount | 121384.07 |
| Total Medicare Standardized Payment Amount | 127693.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 623 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 8583.01 |
| Total Drug Medicare AllowedAmount | 4946.2 |
| Total Drug Medicare PaymentAmount | 4590.66 |
| Total Drug Medicare Standardized Payment Amount | 4590.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 2970 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 257216 |
| Total Medical Medicare Allowed Amount | 160553.89 |
| Total Medical Medicare Payment Amount | 116793.41 |
| Total Medical Medicare Standardized Payment Amount | 123102.43 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 448 |
| Number Of Black or African American Beneficiaries | 44 |
| 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 | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4319 |