| National Provider Identifier [NPI]: | 1700835220 |
| Last Name Of The Provider | SUTHERLAND |
| First Name Of The Provider | JESSE |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2200 S FEDERAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DENVER |
| Zip Code Of The Provider | 802195444 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 866 |
| Number Of Medicare Beneficiaries | 105 |
| Total Submitted Charge Amount | 72875 |
| Total Medicare Allowed Amount | 61067.33 |
| Total Medicare Payment Amount | 42378.03 |
| Total Medicare Standardized Payment Amount | 41379.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 550 |
| Total Drug Medicare AllowedAmount | 300 |
| Total Drug Medicare PaymentAmount | 294.02 |
| Total Drug Medicare Standardized Payment Amount | 294.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 844 |
| Number Of Medicare Beneficiaries With Medical Services | 105 |
| Total Medical Submitted Charge Amount | 72325 |
| Total Medical Medicare Allowed Amount | 60767.33 |
| Total Medical Medicare Payment Amount | 42084.01 |
| Total Medical Medicare Standardized Payment Amount | 41085.44 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 60 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 54 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3869 |