National Provider Identifier [NPI]: |
1649235599 |
Last Name Of The Provider |
PETERS |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4700 E ILIFF AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802226025 |
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 |
58 |
Number Of Services |
1827 |
Number Of Medicare Beneficiaries |
580 |
Total Submitted Charge Amount |
248555 |
Total Medicare Allowed Amount |
186286.69 |
Total Medicare Payment Amount |
137060.03 |
Total Medicare Standardized Payment Amount |
137787.22 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
481 |
Total Drug Medicare AllowedAmount |
272.56 |
Total Drug Medicare PaymentAmount |
260.18 |
Total Drug Medicare Standardized Payment Amount |
260.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
1801 |
Number Of Medicare Beneficiaries With Medical Services |
580 |
Total Medical Submitted Charge Amount |
248074 |
Total Medical Medicare Allowed Amount |
186014.13 |
Total Medical Medicare Payment Amount |
136799.85 |
Total Medical Medicare Standardized Payment Amount |
137527.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
335 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
339 |
Number Of Non Hispanic White Beneficiaries |
529 |
Number Of Black or African American Beneficiaries |
14 |
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 |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.786 |