| National Provider Identifier [NPI]: | 1265480131 |
| Last Name Of The Provider | JAY |
| First Name Of The Provider | KIERAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 E STAR CT A |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTROSE |
| Zip Code Of The Provider | 814016701 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 1036 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 614054.5 |
| Total Medicare Allowed Amount | 181583.66 |
| Total Medicare Payment Amount | 144217.98 |
| Total Medicare Standardized Payment Amount | 142807.31 |
| 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 | 97 |
| Number Of Medical Services | 1036 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 614054.5 |
| Total Medical Medicare Allowed Amount | 181583.66 |
| Total Medical Medicare Payment Amount | 144217.98 |
| Total Medical Medicare Standardized Payment Amount | 142807.31 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 278 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 244 |
| Number Of Male Beneficiaries | 254 |
| Number Of Non Hispanic White Beneficiaries | 453 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9454 |