| National Provider Identifier [NPI]: | 1598083537 |
| Last Name Of The Provider | MAITTA |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D.,PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11100 EUCLID AVE |
| Street Address 2 Of The Provider | UNIVERSITY HOSPITALS CASE MEDICAL CENTER |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441061716 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 373 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 70365 |
| Total Medicare Allowed Amount | 18025.69 |
| Total Medicare Payment Amount | 14049.99 |
| Total Medicare Standardized Payment Amount | 14384.2 |
| 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 | 14 |
| Number Of Medical Services | 373 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 70365 |
| Total Medical Medicare Allowed Amount | 18025.69 |
| Total Medical Medicare Payment Amount | 14049.99 |
| Total Medical Medicare Standardized Payment Amount | 14384.2 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 150 |
| 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 | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 3.1626 |