| National Provider Identifier [NPI]: | 1255321014 |
| Last Name Of The Provider | DREW |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1746 COLE BLVD |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | LAKEWOOD |
| Zip Code Of The Provider | 804013208 |
| 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 | 153 |
| Number Of Services | 7849 |
| Number Of Medicare Beneficiaries | 4841 |
| Total Submitted Charge Amount | 598300 |
| Total Medicare Allowed Amount | 204765.62 |
| Total Medicare Payment Amount | 168166.44 |
| Total Medicare Standardized Payment Amount | 177266.56 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 871 |
| Number Of Beneficiaries Age 65 to 74 | 1975 |
| Number Of Beneficiaries Age 75 to 84 | 1368 |
| Number Of Beneficiaries Age Greater 84 | 627 |
| Number Of Female Beneficiaries | 3646 |
| Number Of Male Beneficiaries | 1195 |
| Number Of Non Hispanic White Beneficiaries | 4388 |
| Number Of Black or African American Beneficiaries | 345 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3772 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1069 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4015 |