National Provider Identifier [NPI]: |
1063497246 |
Last Name Of The Provider |
NAKAMURA |
First Name Of The Provider |
SHAWN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1008 MINNEQUA AVE |
Street Address 2 Of The Provider |
SUITE 1501 |
City Of The Provider |
PUEBLO |
Zip Code Of The Provider |
810043733 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
95 |
Number Of Services |
3959 |
Number Of Medicare Beneficiaries |
496 |
Total Submitted Charge Amount |
555585 |
Total Medicare Allowed Amount |
278925.1 |
Total Medicare Payment Amount |
214761.47 |
Total Medicare Standardized Payment Amount |
212642.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2395 |
Number Of Medicare Beneficiaries With Drug Services |
210 |
Total Drug Submitted ChargeAmount |
63007 |
Total Drug Medicare AllowedAmount |
49758.69 |
Total Drug Medicare PaymentAmount |
38430.47 |
Total Drug Medicare Standardized Payment Amount |
38430.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
91 |
Number Of Medical Services |
1564 |
Number Of Medicare Beneficiaries With Medical Services |
496 |
Total Medical Submitted Charge Amount |
492578 |
Total Medical Medicare Allowed Amount |
229166.41 |
Total Medical Medicare Payment Amount |
176331 |
Total Medical Medicare Standardized Payment Amount |
174212.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
318 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
160 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1117 |