National Provider Identifier [NPI]: |
1720265846 |
Last Name Of The Provider |
TERRA |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1601 E 19TH AVE |
Street Address 2 Of The Provider |
STE 3700 |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802181216 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
6433.5 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
325161 |
Total Medicare Allowed Amount |
124268.46 |
Total Medicare Payment Amount |
96222.99 |
Total Medicare Standardized Payment Amount |
96930.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
4996.5 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
11588 |
Total Drug Medicare AllowedAmount |
4692.37 |
Total Drug Medicare PaymentAmount |
3688.09 |
Total Drug Medicare Standardized Payment Amount |
3688.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
1437 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
313573 |
Total Medical Medicare Allowed Amount |
119576.09 |
Total Medical Medicare Payment Amount |
92534.9 |
Total Medical Medicare Standardized Payment Amount |
93242.63 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
243 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
211 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
3.2273 |