National Provider Identifier [NPI]: |
1689870164 |
Last Name Of The Provider |
SEIBOLD |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12605 E 16TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800452545 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2815 |
Number Of Medicare Beneficiaries |
641 |
Total Submitted Charge Amount |
1926273 |
Total Medicare Allowed Amount |
359168.64 |
Total Medicare Payment Amount |
271748.8 |
Total Medicare Standardized Payment Amount |
271126.36 |
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 |
38 |
Number Of Medical Services |
2815 |
Number Of Medicare Beneficiaries With Medical Services |
641 |
Total Medical Submitted Charge Amount |
1926273 |
Total Medical Medicare Allowed Amount |
359168.64 |
Total Medical Medicare Payment Amount |
271748.8 |
Total Medical Medicare Standardized Payment Amount |
271126.36 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
234 |
Number Of Beneficiaries Age 75 to 84 |
251 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
383 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
422 |
Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
42 |
Number Of Hispanic Beneficiaries |
65 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
501 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2106 |