National Provider Identifier [NPI]: |
1235245689 |
Last Name Of The Provider |
MCLEAN |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7960 S. UNIVERSITY BLVD. |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
CENTENNIAL |
Zip Code Of The Provider |
80122 |
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 |
90 |
Number Of Services |
2780 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
155133.61 |
Total Medicare Allowed Amount |
110135.57 |
Total Medicare Payment Amount |
78664.74 |
Total Medicare Standardized Payment Amount |
79301.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1181 |
Number Of Medicare Beneficiaries With Drug Services |
95 |
Total Drug Submitted ChargeAmount |
10431.8 |
Total Drug Medicare AllowedAmount |
6790.15 |
Total Drug Medicare PaymentAmount |
5195.14 |
Total Drug Medicare Standardized Payment Amount |
5195.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
84 |
Number Of Medical Services |
1599 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
144701.81 |
Total Medical Medicare Allowed Amount |
103345.42 |
Total Medical Medicare Payment Amount |
73469.6 |
Total Medical Medicare Standardized Payment Amount |
74106.61 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
97 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
189 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
23 |
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 |
0.8757 |