National Provider Identifier [NPI]: |
1851303002 |
Last Name Of The Provider |
GAMACHE |
First Name Of The Provider |
LESLIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1721 E 19TH AVE |
Street Address 2 Of The Provider |
SUITE 454 |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802181244 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1564 |
Number Of Medicare Beneficiaries |
224 |
Total Submitted Charge Amount |
158068 |
Total Medicare Allowed Amount |
72954.71 |
Total Medicare Payment Amount |
54916.85 |
Total Medicare Standardized Payment Amount |
54976.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
844 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
37444 |
Total Drug Medicare AllowedAmount |
12222.04 |
Total Drug Medicare PaymentAmount |
9357.63 |
Total Drug Medicare Standardized Payment Amount |
9357.63 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
720 |
Number Of Medicare Beneficiaries With Medical Services |
224 |
Total Medical Submitted Charge Amount |
120624 |
Total Medical Medicare Allowed Amount |
60732.67 |
Total Medical Medicare Payment Amount |
45559.22 |
Total Medical Medicare Standardized Payment Amount |
45618.6 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
165 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3119 |