National Provider Identifier [NPI]: |
1871616722 |
Last Name Of The Provider |
BANNIGAN |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9191 GRANT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
THORNTON |
Zip Code Of The Provider |
802294361 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
669 |
Number Of Medicare Beneficiaries |
585 |
Total Submitted Charge Amount |
524747 |
Total Medicare Allowed Amount |
107126.76 |
Total Medicare Payment Amount |
81344.97 |
Total Medicare Standardized Payment Amount |
74565.03 |
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 |
30 |
Number Of Medical Services |
669 |
Number Of Medicare Beneficiaries With Medical Services |
585 |
Total Medical Submitted Charge Amount |
524747 |
Total Medical Medicare Allowed Amount |
107126.76 |
Total Medical Medicare Payment Amount |
81344.97 |
Total Medical Medicare Standardized Payment Amount |
74565.03 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
205 |
Number Of Beneficiaries Age 65 to 74 |
172 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
271 |
Number Of Non Hispanic White Beneficiaries |
126 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
340 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
447 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
31 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4187 |