National Provider Identifier [NPI]: |
1548275225 |
Last Name Of The Provider |
HOENIG |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 PENNOCK PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805243257 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
439 |
Number Of Medicare Beneficiaries |
170 |
Total Submitted Charge Amount |
38356 |
Total Medicare Allowed Amount |
19868.8 |
Total Medicare Payment Amount |
13871.44 |
Total Medicare Standardized Payment Amount |
13757.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
168 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
1030 |
Total Drug Medicare AllowedAmount |
496.37 |
Total Drug Medicare PaymentAmount |
472.13 |
Total Drug Medicare Standardized Payment Amount |
472.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
271 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
37326 |
Total Medical Medicare Allowed Amount |
19372.43 |
Total Medical Medicare Payment Amount |
13399.31 |
Total Medical Medicare Standardized Payment Amount |
13285.26 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
141 |
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 |
56 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
26 |
Percent Of With Hypertension |
44 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.367 |