National Provider Identifier [NPI]: |
1033197439 |
Last Name Of The Provider |
PINEDA |
First Name Of The Provider |
GILBERT |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 S. POTOMAC ST. |
Street Address 2 Of The Provider |
|
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800125411 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
361 |
Number Of Medicare Beneficiaries |
323 |
Total Submitted Charge Amount |
210687 |
Total Medicare Allowed Amount |
52337.98 |
Total Medicare Payment Amount |
38921.05 |
Total Medicare Standardized Payment Amount |
39032.6 |
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 |
22 |
Number Of Medical Services |
361 |
Number Of Medicare Beneficiaries With Medical Services |
323 |
Total Medical Submitted Charge Amount |
210687 |
Total Medical Medicare Allowed Amount |
52337.98 |
Total Medical Medicare Payment Amount |
38921.05 |
Total Medical Medicare Standardized Payment Amount |
39032.6 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
236 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0416 |