National Provider Identifier [NPI]: |
1043266794 |
Last Name Of The Provider |
DAVIS |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 E HAMPDEN AVE |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
ENGLEWOOD |
Zip Code Of The Provider |
801132736 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gynecological/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
494 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
333401 |
Total Medicare Allowed Amount |
163214.14 |
Total Medicare Payment Amount |
123959.3 |
Total Medicare Standardized Payment Amount |
128083.26 |
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 |
55 |
Number Of Medical Services |
494 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
333401 |
Total Medical Medicare Allowed Amount |
163214.14 |
Total Medical Medicare Payment Amount |
123959.3 |
Total Medical Medicare Standardized Payment Amount |
128083.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
157 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1883 |