National Provider Identifier [NPI]: |
1801900253 |
Last Name Of The Provider |
KAUFFMAN |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1124 E ELIZABETH ST |
Street Address 2 Of The Provider |
BLDG C |
City Of The Provider |
FORT COLLINS |
Zip Code Of The Provider |
805244052 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
982 |
Number Of Medicare Beneficiaries |
234 |
Total Submitted Charge Amount |
80386 |
Total Medicare Allowed Amount |
54348.78 |
Total Medicare Payment Amount |
38183.07 |
Total Medicare Standardized Payment Amount |
38481.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
219 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
3424 |
Total Drug Medicare AllowedAmount |
2931.24 |
Total Drug Medicare PaymentAmount |
2847.62 |
Total Drug Medicare Standardized Payment Amount |
2847.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
763 |
Number Of Medicare Beneficiaries With Medical Services |
234 |
Total Medical Submitted Charge Amount |
76962 |
Total Medical Medicare Allowed Amount |
51417.54 |
Total Medical Medicare Payment Amount |
35335.45 |
Total Medical Medicare Standardized Payment Amount |
35634.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.852 |