National Provider Identifier [NPI]: |
1538287115 |
Last Name Of The Provider |
OSTRAND |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 W 16TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PUEBLO |
Zip Code Of The Provider |
810032745 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
698 |
Number Of Medicare Beneficiaries |
533 |
Total Submitted Charge Amount |
250909.71 |
Total Medicare Allowed Amount |
78517.39 |
Total Medicare Payment Amount |
59134.53 |
Total Medicare Standardized Payment Amount |
59097.66 |
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 |
29 |
Number Of Medical Services |
698 |
Number Of Medicare Beneficiaries With Medical Services |
533 |
Total Medical Submitted Charge Amount |
250909.71 |
Total Medical Medicare Allowed Amount |
78517.39 |
Total Medical Medicare Payment Amount |
59134.53 |
Total Medical Medicare Standardized Payment Amount |
59097.66 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
272 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
324 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
192 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9906 |