National Provider Identifier [NPI]: |
1841253986 |
Last Name Of The Provider |
WEILAND |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2490 W 26TH AVE |
Street Address 2 Of The Provider |
SUITE 220A |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802115314 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
179 |
Number Of Services |
4117.5 |
Number Of Medicare Beneficiaries |
2293 |
Total Submitted Charge Amount |
610106.73 |
Total Medicare Allowed Amount |
149020.53 |
Total Medicare Payment Amount |
115037.17 |
Total Medicare Standardized Payment Amount |
117286.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
934.5 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
2479.73 |
Total Drug Medicare AllowedAmount |
1026.09 |
Total Drug Medicare PaymentAmount |
778.31 |
Total Drug Medicare Standardized Payment Amount |
778.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
172 |
Number Of Medical Services |
3183 |
Number Of Medicare Beneficiaries With Medical Services |
2293 |
Total Medical Submitted Charge Amount |
607627 |
Total Medical Medicare Allowed Amount |
147994.44 |
Total Medical Medicare Payment Amount |
114258.86 |
Total Medical Medicare Standardized Payment Amount |
116508.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
449 |
Number Of Beneficiaries Age 65 to 74 |
881 |
Number Of Beneficiaries Age 75 to 84 |
598 |
Number Of Beneficiaries Age Greater 84 |
365 |
Number Of Female Beneficiaries |
1325 |
Number Of Male Beneficiaries |
968 |
Number Of Non Hispanic White Beneficiaries |
1898 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
44 |
Number Of Hispanic Beneficiaries |
283 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
34 |
Number Of Beneficiaries With Medicare Only Entitlement |
1762 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
531 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5883 |