National Provider Identifier [NPI]: |
1023261534 |
Last Name Of The Provider |
HESTER |
First Name Of The Provider |
JAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 E ELIZABETH #G1 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805244044 |
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 |
30 |
Number Of Services |
1215 |
Number Of Medicare Beneficiaries |
94 |
Total Submitted Charge Amount |
41221 |
Total Medicare Allowed Amount |
28249.68 |
Total Medicare Payment Amount |
19869.57 |
Total Medicare Standardized Payment Amount |
20015.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
801 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
2490 |
Total Drug Medicare AllowedAmount |
1394.55 |
Total Drug Medicare PaymentAmount |
1314.96 |
Total Drug Medicare Standardized Payment Amount |
1314.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
414 |
Number Of Medicare Beneficiaries With Medical Services |
94 |
Total Medical Submitted Charge Amount |
38731 |
Total Medical Medicare Allowed Amount |
26855.13 |
Total Medical Medicare Payment Amount |
18554.61 |
Total Medical Medicare Standardized Payment Amount |
18700.05 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
83 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
68 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
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 |
16 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
24 |
Percent Of With Hypertension |
23 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.886 |