| National Provider Identifier [NPI]: | 1477524957 |
| Last Name Of The Provider | KOEPKE |
| First Name Of The Provider | JERALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 125 RAMPART WAY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | DENVER |
| Zip Code Of The Provider | 802306406 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 3551 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 104928 |
| Total Medicare Allowed Amount | 66775.46 |
| Total Medicare Payment Amount | 48059.23 |
| Total Medicare Standardized Payment Amount | 47968.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 300 |
| Total Drug Medicare AllowedAmount | 228.95 |
| Total Drug Medicare PaymentAmount | 220.9 |
| Total Drug Medicare Standardized Payment Amount | 220.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 3502 |
| Number Of Medicare Beneficiaries With Medical Services | 275 |
| Total Medical Submitted Charge Amount | 104628 |
| Total Medical Medicare Allowed Amount | 66546.51 |
| Total Medical Medicare Payment Amount | 47838.33 |
| Total Medical Medicare Standardized Payment Amount | 47747.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 173 |
| Number Of Male Beneficiaries | 102 |
| Number Of Non Hispanic White Beneficiaries | 259 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 40 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7979 |