National Provider Identifier [NPI]: |
1134381825 |
Last Name Of The Provider |
SACRO |
First Name Of The Provider |
YASMIN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 28TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802053003 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
871 |
Number Of Medicare Beneficiaries |
507 |
Total Submitted Charge Amount |
199577 |
Total Medicare Allowed Amount |
72239.78 |
Total Medicare Payment Amount |
51129.12 |
Total Medicare Standardized Payment Amount |
47833.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
871 |
Number Of Medicare Beneficiaries With Medical Services |
507 |
Total Medical Submitted Charge Amount |
199577 |
Total Medical Medicare Allowed Amount |
72239.78 |
Total Medical Medicare Payment Amount |
51129.12 |
Total Medical Medicare Standardized Payment Amount |
47833.33 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
177 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
365 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
67 |
Number Of Black or African American Beneficiaries |
415 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
264 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6697 |