National Provider Identifier [NPI]: |
1043355241 |
Last Name Of The Provider |
DRAEB |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 MARION STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802181121 |
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 |
32 |
Number Of Services |
406 |
Number Of Medicare Beneficiaries |
99 |
Total Submitted Charge Amount |
28663 |
Total Medicare Allowed Amount |
22568.4 |
Total Medicare Payment Amount |
17519.24 |
Total Medicare Standardized Payment Amount |
17763.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
62 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
4418 |
Total Drug Medicare AllowedAmount |
3958.01 |
Total Drug Medicare PaymentAmount |
3877.27 |
Total Drug Medicare Standardized Payment Amount |
3877.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
344 |
Number Of Medicare Beneficiaries With Medical Services |
99 |
Total Medical Submitted Charge Amount |
24245 |
Total Medical Medicare Allowed Amount |
18610.39 |
Total Medical Medicare Payment Amount |
13641.97 |
Total Medical Medicare Standardized Payment Amount |
13886.36 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
71 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
71 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
15 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7006 |