National Provider Identifier [NPI]: |
1245345818 |
Last Name Of The Provider |
KOMPPA |
First Name Of The Provider |
GLORIA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
777 BANNOCK ST |
Street Address 2 Of The Provider |
MC 7782 |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802044507 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
722 |
Number Of Medicare Beneficiaries |
334 |
Total Submitted Charge Amount |
45391.84 |
Total Medicare Allowed Amount |
18231.18 |
Total Medicare Payment Amount |
15557.12 |
Total Medicare Standardized Payment Amount |
15492.27 |
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 |
13 |
Number Of Medical Services |
722 |
Number Of Medicare Beneficiaries With Medical Services |
334 |
Total Medical Submitted Charge Amount |
45391.84 |
Total Medical Medicare Allowed Amount |
18231.18 |
Total Medical Medicare Payment Amount |
15557.12 |
Total Medical Medicare Standardized Payment Amount |
15492.27 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
81 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
134 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
26 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.121 |