| National Provider Identifier [NPI]: | 1942214671 |
| Last Name Of The Provider | JESS |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1024 LEMAY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 80524 |
| 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 | 192 |
| Number Of Services | 4856 |
| Number Of Medicare Beneficiaries | 3547 |
| Total Submitted Charge Amount | 736619 |
| Total Medicare Allowed Amount | 188506.27 |
| Total Medicare Payment Amount | 137220.86 |
| Total Medicare Standardized Payment Amount | 139812.17 |
| 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 | 192 |
| Number Of Medical Services | 4856 |
| Number Of Medicare Beneficiaries With Medical Services | 3547 |
| Total Medical Submitted Charge Amount | 736619 |
| Total Medical Medicare Allowed Amount | 188506.27 |
| Total Medical Medicare Payment Amount | 137220.86 |
| Total Medical Medicare Standardized Payment Amount | 139812.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 545 |
| Number Of Beneficiaries Age 65 to 74 | 1277 |
| Number Of Beneficiaries Age 75 to 84 | 1084 |
| Number Of Beneficiaries Age Greater 84 | 641 |
| Number Of Female Beneficiaries | 2018 |
| Number Of Male Beneficiaries | 1529 |
| Number Of Non Hispanic White Beneficiaries | 3186 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 269 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2778 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 769 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4271 |