National Provider Identifier [NPI]: |
1043414543 |
Last Name Of The Provider |
PITCHER |
First Name Of The Provider |
GRATIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 E 3RD ST |
Street Address 2 Of The Provider |
ESSENTIA HEALTH DULUTH CLINIC |
City Of The Provider |
DULUTH |
Zip Code Of The Provider |
558051951 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
891 |
Number Of Medicare Beneficiaries |
350 |
Total Submitted Charge Amount |
269702 |
Total Medicare Allowed Amount |
83774.59 |
Total Medicare Payment Amount |
65271.77 |
Total Medicare Standardized Payment Amount |
67307.61 |
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 |
26 |
Number Of Medical Services |
891 |
Number Of Medicare Beneficiaries With Medical Services |
350 |
Total Medical Submitted Charge Amount |
269702 |
Total Medical Medicare Allowed Amount |
83774.59 |
Total Medical Medicare Payment Amount |
65271.77 |
Total Medical Medicare Standardized Payment Amount |
67307.61 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0162 |