National Provider Identifier [NPI]: |
1912915638 |
Last Name Of The Provider |
KOONTZ |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7780 S BROADWAY STE 260 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLETON |
Zip Code Of The Provider |
801222633 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
541 |
Number Of Medicare Beneficiaries |
344 |
Total Submitted Charge Amount |
118047.26 |
Total Medicare Allowed Amount |
59555.7 |
Total Medicare Payment Amount |
44735.11 |
Total Medicare Standardized Payment Amount |
44697.89 |
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 |
27 |
Number Of Medical Services |
541 |
Number Of Medicare Beneficiaries With Medical Services |
344 |
Total Medical Submitted Charge Amount |
118047.26 |
Total Medical Medicare Allowed Amount |
59555.7 |
Total Medical Medicare Payment Amount |
44735.11 |
Total Medical Medicare Standardized Payment Amount |
44697.89 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
147 |
Number Of Non Hispanic White Beneficiaries |
257 |
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 |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
30 |
Average HCC Risk Score Of Beneficiaries |
1.8298 |