National Provider Identifier [NPI]: |
1467478602 |
Last Name Of The Provider |
DILL |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 N NEVADA AVE |
Street Address 2 Of The Provider |
FRONT RANGE EMERGENCY SPECIALIST |
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809076819 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
268 |
Number Of Medicare Beneficiaries |
232 |
Total Submitted Charge Amount |
95527 |
Total Medicare Allowed Amount |
23876.44 |
Total Medicare Payment Amount |
17752.1 |
Total Medicare Standardized Payment Amount |
21097.88 |
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 |
33 |
Number Of Medical Services |
268 |
Number Of Medicare Beneficiaries With Medical Services |
232 |
Total Medical Submitted Charge Amount |
95527 |
Total Medical Medicare Allowed Amount |
23876.44 |
Total Medical Medicare Payment Amount |
17752.1 |
Total Medical Medicare Standardized Payment Amount |
21097.88 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
192 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.519 |