| National Provider Identifier [NPI]: | 1699741223 |
| Last Name Of The Provider | PAQUELET |
| First Name Of The Provider | JEAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1024 LEMAY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805243929 |
| 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 | 31 |
| Number Of Services | 6131 |
| Number Of Medicare Beneficiaries | 2991 |
| Total Submitted Charge Amount | 357369 |
| Total Medicare Allowed Amount | 138598.79 |
| Total Medicare Payment Amount | 126216.64 |
| Total Medicare Standardized Payment Amount | 127797.86 |
| 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 | 31 |
| Number Of Medical Services | 6131 |
| Number Of Medicare Beneficiaries With Medical Services | 2991 |
| Total Medical Submitted Charge Amount | 357369 |
| Total Medical Medicare Allowed Amount | 138598.79 |
| Total Medical Medicare Payment Amount | 126216.64 |
| Total Medical Medicare Standardized Payment Amount | 127797.86 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 1817 |
| Number Of Beneficiaries Age 75 to 84 | 808 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 2977 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 2811 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 126 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2783 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 208 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 2 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.6922 |