National Provider Identifier [NPI]: |
1497720403 |
Last Name Of The Provider |
HO |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
499 E HAMPDEN AVE |
Street Address 2 Of The Provider |
STE 450 |
City Of The Provider |
ENGLEWOOD |
Zip Code Of The Provider |
801132780 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
2634 |
Number Of Medicare Beneficiaries |
435 |
Total Submitted Charge Amount |
262173 |
Total Medicare Allowed Amount |
178085.55 |
Total Medicare Payment Amount |
133038.45 |
Total Medicare Standardized Payment Amount |
131187.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
68 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
18654 |
Total Drug Medicare AllowedAmount |
16040.46 |
Total Drug Medicare PaymentAmount |
12532.27 |
Total Drug Medicare Standardized Payment Amount |
12532.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
2566 |
Number Of Medicare Beneficiaries With Medical Services |
435 |
Total Medical Submitted Charge Amount |
243519 |
Total Medical Medicare Allowed Amount |
162045.09 |
Total Medical Medicare Payment Amount |
120506.18 |
Total Medical Medicare Standardized Payment Amount |
118655.56 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
413 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8447 |