National Provider Identifier [NPI]: |
1013983196 |
Last Name Of The Provider |
DREIMAN |
First Name Of The Provider |
CHESTER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4350 WADSWORTH BLVD |
Street Address 2 Of The Provider |
#201 |
City Of The Provider |
WHEAT RIDGE |
Zip Code Of The Provider |
800334641 |
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 |
8 |
Number Of Services |
321 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
127838 |
Total Medicare Allowed Amount |
57709.47 |
Total Medicare Payment Amount |
45126.16 |
Total Medicare Standardized Payment Amount |
45161.97 |
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 |
8 |
Number Of Medical Services |
321 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
127838 |
Total Medical Medicare Allowed Amount |
57709.47 |
Total Medical Medicare Payment Amount |
45126.16 |
Total Medical Medicare Standardized Payment Amount |
45161.97 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
147 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.3596 |