National Provider Identifier [NPI]: |
1457435034 |
Last Name Of The Provider |
MERCER |
First Name Of The Provider |
JEANNETTE |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 PENNOCK PL |
Street Address 2 Of The Provider |
STE 121 |
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805243257 |
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 |
39 |
Number Of Services |
256 |
Number Of Medicare Beneficiaries |
95 |
Total Submitted Charge Amount |
21084 |
Total Medicare Allowed Amount |
11140.03 |
Total Medicare Payment Amount |
7562.48 |
Total Medicare Standardized Payment Amount |
7575.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
66 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
140 |
Total Drug Medicare AllowedAmount |
60.73 |
Total Drug Medicare PaymentAmount |
47.64 |
Total Drug Medicare Standardized Payment Amount |
47.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
190 |
Number Of Medicare Beneficiaries With Medical Services |
95 |
Total Medical Submitted Charge Amount |
20944 |
Total Medical Medicare Allowed Amount |
11079.3 |
Total Medical Medicare Payment Amount |
7514.84 |
Total Medical Medicare Standardized Payment Amount |
7528.12 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
76 |
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 |
45 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
26 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1341 |