| National Provider Identifier [NPI]: | 1740244342 |
| Last Name Of The Provider | PEVNY |
| First Name Of The Provider | TOMAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1450 E VALLEY RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | BASALT |
| Zip Code Of The Provider | 816218304 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 3145 |
| Number Of Medicare Beneficiaries | 373 |
| Total Submitted Charge Amount | 1016759 |
| Total Medicare Allowed Amount | 234165.93 |
| Total Medicare Payment Amount | 174336.09 |
| Total Medicare Standardized Payment Amount | 171621.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1531 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 127059 |
| Total Drug Medicare AllowedAmount | 53244.44 |
| Total Drug Medicare PaymentAmount | 41200.93 |
| Total Drug Medicare Standardized Payment Amount | 41200.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 1614 |
| Number Of Medicare Beneficiaries With Medical Services | 373 |
| Total Medical Submitted Charge Amount | 889700 |
| Total Medical Medicare Allowed Amount | 180921.49 |
| Total Medical Medicare Payment Amount | 133135.16 |
| Total Medical Medicare Standardized Payment Amount | 130420.85 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 262 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 351 |
| 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 | 359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 5 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 6 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6667 |