National Provider Identifier [NPI]: |
1245202845 |
Last Name Of The Provider |
RUGGLES |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3245 INTERNATIONAL CIR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809103152 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
4229 |
Number Of Medicare Beneficiaries |
745 |
Total Submitted Charge Amount |
363671 |
Total Medicare Allowed Amount |
214101.08 |
Total Medicare Payment Amount |
149367.34 |
Total Medicare Standardized Payment Amount |
143162.89 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
305 |
Number Of Beneficiaries Age 75 to 84 |
305 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
348 |
Number Of Male Beneficiaries |
397 |
Number Of Non Hispanic White Beneficiaries |
711 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
733 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9331 |