| National Provider Identifier [NPI]: | 1679661011 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | JEFFREY |
| 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 | 1390 KELLY JOHNSON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809203908 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 203 |
| Number Of Services | 9643 |
| Number Of Medicare Beneficiaries | 2290 |
| Total Submitted Charge Amount | 504921.9 |
| Total Medicare Allowed Amount | 180169.02 |
| Total Medicare Payment Amount | 141464.65 |
| Total Medicare Standardized Payment Amount | 142752.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6219 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 3133.8 |
| Total Drug Medicare AllowedAmount | 1204.95 |
| Total Drug Medicare PaymentAmount | 944.54 |
| Total Drug Medicare Standardized Payment Amount | 944.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 201 |
| Number Of Medical Services | 3424 |
| Number Of Medicare Beneficiaries With Medical Services | 2290 |
| Total Medical Submitted Charge Amount | 501788.1 |
| Total Medical Medicare Allowed Amount | 178964.07 |
| Total Medical Medicare Payment Amount | 140520.11 |
| Total Medical Medicare Standardized Payment Amount | 141807.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 317 |
| Number Of Beneficiaries Age 65 to 74 | 980 |
| Number Of Beneficiaries Age 75 to 84 | 692 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 1384 |
| Number Of Male Beneficiaries | 906 |
| Number Of Non Hispanic White Beneficiaries | 2027 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 111 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1975 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 315 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.518 |