| National Provider Identifier [NPI]: | 1669479549 |
| Last Name Of The Provider | STELMACH |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3225 I-70 BUSINESS LOOP |
| Street Address 2 Of The Provider | STE A4 |
| City Of The Provider | CLIFTON |
| Zip Code Of The Provider | 815207687 |
| 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 | 72 |
| Number Of Services | 1455 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 122210.5 |
| Total Medicare Allowed Amount | 62675.16 |
| Total Medicare Payment Amount | 41802.52 |
| Total Medicare Standardized Payment Amount | 42713.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 170 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 2001.5 |
| Total Drug Medicare AllowedAmount | 1560.59 |
| Total Drug Medicare PaymentAmount | 1379.33 |
| Total Drug Medicare Standardized Payment Amount | 1379.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 1285 |
| Number Of Medicare Beneficiaries With Medical Services | 186 |
| Total Medical Submitted Charge Amount | 120209 |
| Total Medical Medicare Allowed Amount | 61114.57 |
| Total Medical Medicare Payment Amount | 40423.19 |
| Total Medical Medicare Standardized Payment Amount | 41334.64 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 173 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8705 |