National Provider Identifier [NPI]: |
1073501292 |
Last Name Of The Provider |
BRANTLEY |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2312 N NEVADA AVE STE 400 |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809075320 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
154 |
Number Of Services |
79764 |
Number Of Medicare Beneficiaries |
900 |
Total Submitted Charge Amount |
4698152.5 |
Total Medicare Allowed Amount |
1343202.6 |
Total Medicare Payment Amount |
1042759.35 |
Total Medicare Standardized Payment Amount |
1040792.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
74 |
Number Of Drug Services |
74525 |
Number Of Medicare Beneficiaries With Drug Services |
390 |
Total Drug Submitted ChargeAmount |
3793569.5 |
Total Drug Medicare AllowedAmount |
1072627.85 |
Total Drug Medicare PaymentAmount |
832000.24 |
Total Drug Medicare Standardized Payment Amount |
832000.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
5239 |
Number Of Medicare Beneficiaries With Medical Services |
900 |
Total Medical Submitted Charge Amount |
904583 |
Total Medical Medicare Allowed Amount |
270574.75 |
Total Medical Medicare Payment Amount |
210759.11 |
Total Medical Medicare Standardized Payment Amount |
208792.62 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
407 |
Number Of Beneficiaries Age 75 to 84 |
313 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
484 |
Number Of Male Beneficiaries |
416 |
Number Of Non Hispanic White Beneficiaries |
776 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
826 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
38 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8858 |