| National Provider Identifier [NPI]: | 1639174758 |
| Last Name Of The Provider | LANDBLOM |
| First Name Of The Provider | JEROME |
| 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 | 1925 W MOUNTAIN VIEW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LONGMONT |
| Zip Code Of The Provider | 805013128 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 5594 |
| Number Of Medicare Beneficiaries | 343 |
| Total Submitted Charge Amount | 198682.59 |
| Total Medicare Allowed Amount | 148304.37 |
| Total Medicare Payment Amount | 115993.86 |
| Total Medicare Standardized Payment Amount | 116629.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1582 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 7431 |
| Total Drug Medicare AllowedAmount | 4613.66 |
| Total Drug Medicare PaymentAmount | 4456.7 |
| Total Drug Medicare Standardized Payment Amount | 4456.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 4012 |
| Number Of Medicare Beneficiaries With Medical Services | 343 |
| Total Medical Submitted Charge Amount | 191251.59 |
| Total Medical Medicare Allowed Amount | 143690.71 |
| Total Medical Medicare Payment Amount | 111537.16 |
| Total Medical Medicare Standardized Payment Amount | 112173.01 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 172 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 306 |
| 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 | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1439 |