| National Provider Identifier [NPI]: | 1336147867 |
| Last Name Of The Provider | LITKE |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 403 W CAMPBELL RD |
| Street Address 2 Of The Provider | STE 320 |
| City Of The Provider | RICHARDSON |
| Zip Code Of The Provider | 750803466 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 3141 |
| Number Of Medicare Beneficiaries | 227 |
| Total Submitted Charge Amount | 664716 |
| Total Medicare Allowed Amount | 144254.91 |
| Total Medicare Payment Amount | 107873.74 |
| Total Medicare Standardized Payment Amount | 112544.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2231 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 69630 |
| Total Drug Medicare AllowedAmount | 27401.36 |
| Total Drug Medicare PaymentAmount | 21125.81 |
| Total Drug Medicare Standardized Payment Amount | 21125.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 910 |
| Number Of Medicare Beneficiaries With Medical Services | 227 |
| Total Medical Submitted Charge Amount | 595086 |
| Total Medical Medicare Allowed Amount | 116853.55 |
| Total Medical Medicare Payment Amount | 86747.93 |
| Total Medical Medicare Standardized Payment Amount | 91418.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 167 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 204 |
| Number Of Black or African American Beneficiaries | |
| 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 | 212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0032 |