| National Provider Identifier [NPI]: | 1184687469 |
| Last Name Of The Provider | CHAPMAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2315 E HARMONY RD |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805288620 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 1373 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 299181.45 |
| Total Medicare Allowed Amount | 144042.1 |
| Total Medicare Payment Amount | 110608.45 |
| Total Medicare Standardized Payment Amount | 107601.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 670 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 21400 |
| Total Drug Medicare AllowedAmount | 17682.43 |
| Total Drug Medicare PaymentAmount | 13829.16 |
| Total Drug Medicare Standardized Payment Amount | 13829.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 703 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 277781.45 |
| Total Medical Medicare Allowed Amount | 126359.67 |
| Total Medical Medicare Payment Amount | 96779.29 |
| Total Medical Medicare Standardized Payment Amount | 93771.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 142 |
| 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 | 138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2557 |