National Provider Identifier [NPI]: |
1457348724 |
Last Name Of The Provider |
HUTCHINSON |
First Name Of The Provider |
DAWN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
121 E. GALENA AVE. |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
CRESTONE |
Zip Code Of The Provider |
811310852 |
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 |
20 |
Number Of Services |
458 |
Number Of Medicare Beneficiaries |
60 |
Total Submitted Charge Amount |
43973.85 |
Total Medicare Allowed Amount |
38913.44 |
Total Medicare Payment Amount |
27550.82 |
Total Medicare Standardized Payment Amount |
27539.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
537.29 |
Total Drug Medicare AllowedAmount |
400.09 |
Total Drug Medicare PaymentAmount |
392.04 |
Total Drug Medicare Standardized Payment Amount |
392.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
432 |
Number Of Medicare Beneficiaries With Medical Services |
60 |
Total Medical Submitted Charge Amount |
43436.56 |
Total Medical Medicare Allowed Amount |
38513.35 |
Total Medical Medicare Payment Amount |
27158.78 |
Total Medical Medicare Standardized Payment Amount |
27147.68 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7351 |