National Provider Identifier [NPI]: |
1518108075 |
Last Name Of The Provider |
MCCLORY |
First Name Of The Provider |
INGE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12631 E 17TH AVE |
Street Address 2 Of The Provider |
MAIL STOP B130 |
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800452527 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
88 |
Number Of Medicare Beneficiaries |
54 |
Total Submitted Charge Amount |
7397 |
Total Medicare Allowed Amount |
5704.52 |
Total Medicare Payment Amount |
3574.1 |
Total Medicare Standardized Payment Amount |
4375.76 |
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 |
6 |
Number Of Medical Services |
88 |
Number Of Medicare Beneficiaries With Medical Services |
54 |
Total Medical Submitted Charge Amount |
7397 |
Total Medical Medicare Allowed Amount |
5704.52 |
Total Medical Medicare Payment Amount |
3574.1 |
Total Medical Medicare Standardized Payment Amount |
4375.76 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
26 |
Number Of Male Beneficiaries |
28 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
43 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
|
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6003 |