National Provider Identifier [NPI]: |
1679737084 |
Last Name Of The Provider |
WATTS |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2803 ROSLYN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802382624 |
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 |
23 |
Number Of Services |
152 |
Number Of Medicare Beneficiaries |
48 |
Total Submitted Charge Amount |
11586 |
Total Medicare Allowed Amount |
10071.66 |
Total Medicare Payment Amount |
7781.98 |
Total Medicare Standardized Payment Amount |
7761 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
2719 |
Total Drug Medicare AllowedAmount |
2035.07 |
Total Drug Medicare PaymentAmount |
1994.33 |
Total Drug Medicare Standardized Payment Amount |
1994.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
126 |
Number Of Medicare Beneficiaries With Medical Services |
48 |
Total Medical Submitted Charge Amount |
8867 |
Total Medical Medicare Allowed Amount |
8036.59 |
Total Medical Medicare Payment Amount |
5787.65 |
Total Medical Medicare Standardized Payment Amount |
5766.67 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
35 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
35 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8577 |