National Provider Identifier [NPI]: |
1265405930 |
Last Name Of The Provider |
VELLMAN |
First Name Of The Provider |
W |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11600 W 2ND PL |
Street Address 2 Of The Provider |
ST. ANTHONY HOSPITAL, EMERGENCY DEPT. |
City Of The Provider |
LAKEWOOD |
Zip Code Of The Provider |
802281527 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
653 |
Number Of Medicare Beneficiaries |
392 |
Total Submitted Charge Amount |
268453 |
Total Medicare Allowed Amount |
68449.76 |
Total Medicare Payment Amount |
52544.34 |
Total Medicare Standardized Payment Amount |
52624.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
653 |
Number Of Medicare Beneficiaries With Medical Services |
392 |
Total Medical Submitted Charge Amount |
268453 |
Total Medical Medicare Allowed Amount |
68449.76 |
Total Medical Medicare Payment Amount |
52544.34 |
Total Medical Medicare Standardized Payment Amount |
52624.27 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
318 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0382 |