| National Provider Identifier [NPI]: | 1437230158 |
| Last Name Of The Provider | POOLE |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 KEN PRATT BLVD |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | LONGMONT |
| Zip Code Of The Provider | 805016567 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1232 |
| Number Of Medicare Beneficiaries | 278 |
| Total Submitted Charge Amount | 121228 |
| Total Medicare Allowed Amount | 82525.42 |
| Total Medicare Payment Amount | 63970.29 |
| Total Medicare Standardized Payment Amount | 64054.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 228 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 1781 |
| Total Drug Medicare AllowedAmount | 1546.24 |
| Total Drug Medicare PaymentAmount | 1507.11 |
| Total Drug Medicare Standardized Payment Amount | 1507.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1004 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 119447 |
| Total Medical Medicare Allowed Amount | 80979.18 |
| Total Medical Medicare Payment Amount | 62463.18 |
| Total Medical Medicare Standardized Payment Amount | 62547.62 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| 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 | 256 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9197 |