| National Provider Identifier [NPI]: | 1588664130 |
| Last Name Of The Provider | MAINO |
| First Name Of The Provider | KIMBERLY |
| 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 | 13701 E MISSISSIPPI AVE STE 320 |
| Street Address 2 Of The Provider | |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 800126142 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 2189 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 977546 |
| Total Medicare Allowed Amount | 527024.14 |
| Total Medicare Payment Amount | 407387.44 |
| Total Medicare Standardized Payment Amount | 384990.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 5340 |
| Total Drug Medicare AllowedAmount | 5288 |
| Total Drug Medicare PaymentAmount | 4145.71 |
| Total Drug Medicare Standardized Payment Amount | 4145.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 2167 |
| Number Of Medicare Beneficiaries With Medical Services | 413 |
| Total Medical Submitted Charge Amount | 972206 |
| Total Medical Medicare Allowed Amount | 521736.14 |
| Total Medical Medicare Payment Amount | 403241.73 |
| Total Medical Medicare Standardized Payment Amount | 380844.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 230 |
| Number Of Non Hispanic White Beneficiaries | 396 |
| 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 | 401 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9341 |