National Provider Identifier [NPI]: |
1821300674 |
Last Name Of The Provider |
WARD |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1236 E ELIZABETH ST STE 3 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805244000 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1072 |
Number Of Medicare Beneficiaries |
483 |
Total Submitted Charge Amount |
204079.44 |
Total Medicare Allowed Amount |
110831.5 |
Total Medicare Payment Amount |
85556.24 |
Total Medicare Standardized Payment Amount |
85915.43 |
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 |
19 |
Number Of Medical Services |
1072 |
Number Of Medicare Beneficiaries With Medical Services |
483 |
Total Medical Submitted Charge Amount |
204079.44 |
Total Medical Medicare Allowed Amount |
110831.5 |
Total Medical Medicare Payment Amount |
85556.24 |
Total Medical Medicare Standardized Payment Amount |
85915.43 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
129 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
213 |
Number Of Non Hispanic White Beneficiaries |
444 |
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 |
375 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0013 |