National Provider Identifier [NPI]: |
1790867901 |
Last Name Of The Provider |
VO |
First Name Of The Provider |
HUE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 S FEDERAL BLVD SUITE 1 |
Street Address 2 Of The Provider |
|
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802195472 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
885 |
Number Of Medicare Beneficiaries |
93 |
Total Submitted Charge Amount |
84284 |
Total Medicare Allowed Amount |
54055 |
Total Medicare Payment Amount |
37562.41 |
Total Medicare Standardized Payment Amount |
37441.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
71 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
3475 |
Total Drug Medicare AllowedAmount |
2688.01 |
Total Drug Medicare PaymentAmount |
2631.11 |
Total Drug Medicare Standardized Payment Amount |
2631.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
814 |
Number Of Medicare Beneficiaries With Medical Services |
93 |
Total Medical Submitted Charge Amount |
80809 |
Total Medical Medicare Allowed Amount |
51366.99 |
Total Medical Medicare Payment Amount |
34931.3 |
Total Medical Medicare Standardized Payment Amount |
34810.31 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
12 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
61 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
26 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
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 |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
14 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9692 |