| National Provider Identifier [NPI]: | 1710963962 |
| Last Name Of The Provider | HORNUNG |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 745 RUSSELL ST. |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRAIG |
| Zip Code Of The Provider | 816252019 |
| 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 | 11 |
| Number Of Services | 1279 |
| Number Of Medicare Beneficiaries | 532 |
| Total Submitted Charge Amount | 43424.5 |
| Total Medicare Allowed Amount | 42081.31 |
| Total Medicare Payment Amount | 41238.58 |
| Total Medicare Standardized Payment Amount | 43492 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 637 |
| Number Of Medicare Beneficiaries With Drug Services | 529 |
| Total Drug Submitted ChargeAmount | 29621.5 |
| Total Drug Medicare AllowedAmount | 28278.31 |
| Total Drug Medicare PaymentAmount | 27711.64 |
| Total Drug Medicare Standardized Payment Amount | 27711.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 3 |
| Number Of Medical Services | 642 |
| Number Of Medicare Beneficiaries With Medical Services | 532 |
| Total Medical Submitted Charge Amount | 13803 |
| Total Medical Medicare Allowed Amount | 13803 |
| Total Medical Medicare Payment Amount | 13526.94 |
| Total Medical Medicare Standardized Payment Amount | 15780.36 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 250 |
| Number Of Non Hispanic White Beneficiaries | 495 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 30 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6661 |