National Provider Identifier [NPI]: |
1629044169 |
Last Name Of The Provider |
HERBERT |
First Name Of The Provider |
KENT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7641 MCLAUGHLIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEYTON |
Zip Code Of The Provider |
808314715 |
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 |
26 |
Number Of Services |
321 |
Number Of Medicare Beneficiaries |
250 |
Total Submitted Charge Amount |
236620 |
Total Medicare Allowed Amount |
37664.58 |
Total Medicare Payment Amount |
28558.02 |
Total Medicare Standardized Payment Amount |
29095.83 |
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 |
26 |
Number Of Medical Services |
321 |
Number Of Medicare Beneficiaries With Medical Services |
250 |
Total Medical Submitted Charge Amount |
236620 |
Total Medical Medicare Allowed Amount |
37664.58 |
Total Medical Medicare Payment Amount |
28558.02 |
Total Medical Medicare Standardized Payment Amount |
29095.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.2359 |