National Provider Identifier [NPI]: |
1174605893 |
Last Name Of The Provider |
LELESZI |
First Name Of The Provider |
JAIME |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MSPT,CMT,MT,CSCS |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7821 W 38TH AVE |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
WHEAT RIDGE |
Zip Code Of The Provider |
800336109 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
587 |
Number Of Medicare Beneficiaries |
30 |
Total Submitted Charge Amount |
20951 |
Total Medicare Allowed Amount |
15721.1 |
Total Medicare Payment Amount |
12112.51 |
Total Medicare Standardized Payment Amount |
6245.95 |
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 |
8 |
Number Of Medical Services |
587 |
Number Of Medicare Beneficiaries With Medical Services |
30 |
Total Medical Submitted Charge Amount |
20951 |
Total Medical Medicare Allowed Amount |
15721.1 |
Total Medical Medicare Payment Amount |
12112.51 |
Total Medical Medicare Standardized Payment Amount |
6245.95 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
19 |
Number Of Male Beneficiaries |
11 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
47 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
|
Percent Of With Hypertension |
|
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0727 |