| National Provider Identifier [NPI]: | 1215986476 |
| Last Name Of The Provider | ROTMAN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 S SHIELDS ST |
| Street Address 2 Of The Provider | BUILDING I |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805261827 |
| 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 | 84 |
| Number Of Services | 1505 |
| Number Of Medicare Beneficiaries | 365 |
| Total Submitted Charge Amount | 132063 |
| Total Medicare Allowed Amount | 84584.64 |
| Total Medicare Payment Amount | 58860.24 |
| Total Medicare Standardized Payment Amount | 59062.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 219 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 6929 |
| Total Drug Medicare AllowedAmount | 6304 |
| Total Drug Medicare PaymentAmount | 6127.92 |
| Total Drug Medicare Standardized Payment Amount | 6127.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1286 |
| Number Of Medicare Beneficiaries With Medical Services | 363 |
| Total Medical Submitted Charge Amount | 125134 |
| Total Medical Medicare Allowed Amount | 78280.64 |
| Total Medical Medicare Payment Amount | 52732.32 |
| Total Medical Medicare Standardized Payment Amount | 52934.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 170 |
| Number Of Non Hispanic White Beneficiaries | 340 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8102 |