| National Provider Identifier [NPI]: | 1710905997 |
| Last Name Of The Provider | DUNNAM-SMITH |
| First Name Of The Provider | GINGER |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 704 EDWARDS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WESTCLIFFE |
| Zip Code Of The Provider | 812528588 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 1752 |
| Number Of Medicare Beneficiaries | 503 |
| Total Submitted Charge Amount | 190540.28 |
| Total Medicare Allowed Amount | 66939.88 |
| Total Medicare Payment Amount | 51400.83 |
| Total Medicare Standardized Payment Amount | 51527.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 45 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 656.65 |
| Total Drug Medicare AllowedAmount | 185.04 |
| Total Drug Medicare PaymentAmount | 168.7 |
| Total Drug Medicare Standardized Payment Amount | 168.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 1707 |
| Number Of Medicare Beneficiaries With Medical Services | 502 |
| Total Medical Submitted Charge Amount | 189883.63 |
| Total Medical Medicare Allowed Amount | 66754.84 |
| Total Medical Medicare Payment Amount | 51232.13 |
| Total Medical Medicare Standardized Payment Amount | 51358.68 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 423 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8891 |