| National Provider Identifier [NPI]: | 1548451727 |
| Last Name Of The Provider | JESSE |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12605 E 16TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 800452545 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 5703 |
| Number Of Medicare Beneficiaries | 3199 |
| Total Submitted Charge Amount | 578638 |
| Total Medicare Allowed Amount | 131254.72 |
| Total Medicare Payment Amount | 99130.72 |
| Total Medicare Standardized Payment Amount | 98005.38 |
| 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 | 152 |
| Number Of Medical Services | 5703 |
| Number Of Medicare Beneficiaries With Medical Services | 3199 |
| Total Medical Submitted Charge Amount | 578638 |
| Total Medical Medicare Allowed Amount | 131254.72 |
| Total Medical Medicare Payment Amount | 99130.72 |
| Total Medical Medicare Standardized Payment Amount | 98005.38 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 802 |
| Number Of Beneficiaries Age 65 to 74 | 1419 |
| Number Of Beneficiaries Age 75 to 84 | 755 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 1939 |
| Number Of Male Beneficiaries | 1260 |
| Number Of Non Hispanic White Beneficiaries | 2355 |
| Number Of Black or African American Beneficiaries | 386 |
| Number Of AsianPacific Islander Beneficiaries | 92 |
| Number Of Hispanic Beneficiaries | 290 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2390 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 809 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5311 |