National Provider Identifier [NPI]: |
1841494465 |
Last Name Of The Provider |
GRAY |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
535 16TH ST |
Street Address 2 Of The Provider |
SUITE 750 |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802024235 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
447 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
84051.82 |
Total Medicare Allowed Amount |
56278.35 |
Total Medicare Payment Amount |
43040.4 |
Total Medicare Standardized Payment Amount |
44812.01 |
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 |
16 |
Number Of Medical Services |
447 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
84051.82 |
Total Medical Medicare Allowed Amount |
56278.35 |
Total Medical Medicare Payment Amount |
43040.4 |
Total Medical Medicare Standardized Payment Amount |
44812.01 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
212 |
Number Of Black or African American Beneficiaries |
25 |
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 |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9233 |