National Provider Identifier [NPI]: |
1235276510 |
Last Name Of The Provider |
MITCHELL |
First Name Of The Provider |
NIA |
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 |
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE |
Street Address 2 Of The Provider |
4200 E. 9TH AVE. |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802620001 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
173 |
Number Of Medicare Beneficiaries |
65 |
Total Submitted Charge Amount |
24823.62 |
Total Medicare Allowed Amount |
12462.68 |
Total Medicare Payment Amount |
9204.32 |
Total Medicare Standardized Payment Amount |
9178.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
475 |
Total Drug Medicare AllowedAmount |
288.14 |
Total Drug Medicare PaymentAmount |
282.38 |
Total Drug Medicare Standardized Payment Amount |
282.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
160 |
Number Of Medicare Beneficiaries With Medical Services |
65 |
Total Medical Submitted Charge Amount |
24348.62 |
Total Medical Medicare Allowed Amount |
12174.54 |
Total Medical Medicare Payment Amount |
8921.94 |
Total Medical Medicare Standardized Payment Amount |
8896.26 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
26 |
Number Of Non Hispanic White Beneficiaries |
19 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
23 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
18 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9558 |