National Provider Identifier [NPI]: |
1750437356 |
Last Name Of The Provider |
DAVIDSON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12605 E 16TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800452545 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
2075 |
Number Of Medicare Beneficiaries |
1180 |
Total Submitted Charge Amount |
150562 |
Total Medicare Allowed Amount |
35502.76 |
Total Medicare Payment Amount |
26875.97 |
Total Medicare Standardized Payment Amount |
26054.32 |
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 |
70 |
Number Of Medical Services |
2075 |
Number Of Medicare Beneficiaries With Medical Services |
1180 |
Total Medical Submitted Charge Amount |
150562 |
Total Medical Medicare Allowed Amount |
35502.76 |
Total Medical Medicare Payment Amount |
26875.97 |
Total Medical Medicare Standardized Payment Amount |
26054.32 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
360 |
Number Of Beneficiaries Age 65 to 74 |
442 |
Number Of Beneficiaries Age 75 to 84 |
269 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
571 |
Number Of Male Beneficiaries |
609 |
Number Of Non Hispanic White Beneficiaries |
850 |
Number Of Black or African American Beneficiaries |
135 |
Number Of AsianPacific Islander Beneficiaries |
36 |
Number Of Hispanic Beneficiaries |
131 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
796 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
384 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.248 |