National Provider Identifier [NPI]: |
1710915095 |
Last Name Of The Provider |
DIMEN |
First Name Of The Provider |
JOSE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2190 E 11TH AVE |
Street Address 2 Of The Provider |
#707 |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802062980 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
2689 |
Number Of Medicare Beneficiaries |
1151 |
Total Submitted Charge Amount |
442115 |
Total Medicare Allowed Amount |
174403.74 |
Total Medicare Payment Amount |
131475.72 |
Total Medicare Standardized Payment Amount |
137350.55 |
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 |
80 |
Number Of Medical Services |
2689 |
Number Of Medicare Beneficiaries With Medical Services |
1151 |
Total Medical Submitted Charge Amount |
442115 |
Total Medical Medicare Allowed Amount |
174403.74 |
Total Medical Medicare Payment Amount |
131475.72 |
Total Medical Medicare Standardized Payment Amount |
137350.55 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
361 |
Number Of Beneficiaries Age 75 to 84 |
442 |
Number Of Beneficiaries Age Greater 84 |
262 |
Number Of Female Beneficiaries |
572 |
Number Of Male Beneficiaries |
579 |
Number Of Non Hispanic White Beneficiaries |
1125 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1020 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3289 |