National Provider Identifier [NPI]: |
1982606539 |
Last Name Of The Provider |
VALENCIA |
First Name Of The Provider |
WARREN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2030 MOUNTAIN VIEW AVE |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
LONGMONT |
Zip Code Of The Provider |
805013178 |
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 |
27 |
Number Of Services |
2345 |
Number Of Medicare Beneficiaries |
275 |
Total Submitted Charge Amount |
231301 |
Total Medicare Allowed Amount |
141141.62 |
Total Medicare Payment Amount |
96610.69 |
Total Medicare Standardized Payment Amount |
99351.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
60 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
1403 |
Total Drug Medicare AllowedAmount |
902.05 |
Total Drug Medicare PaymentAmount |
879.16 |
Total Drug Medicare Standardized Payment Amount |
879.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
2285 |
Number Of Medicare Beneficiaries With Medical Services |
275 |
Total Medical Submitted Charge Amount |
229898 |
Total Medical Medicare Allowed Amount |
140239.57 |
Total Medical Medicare Payment Amount |
95731.53 |
Total Medical Medicare Standardized Payment Amount |
98471.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
254 |
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 |
260 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
4 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8745 |