National Provider Identifier [NPI]: |
1114155348 |
Last Name Of The Provider |
COLWELL |
First Name Of The Provider |
RALPH |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3150 N 12TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND JUNCTION |
Zip Code Of The Provider |
815062863 |
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 |
81 |
Number Of Services |
842 |
Number Of Medicare Beneficiaries |
157 |
Total Submitted Charge Amount |
78684 |
Total Medicare Allowed Amount |
39489.53 |
Total Medicare Payment Amount |
30213.9 |
Total Medicare Standardized Payment Amount |
30571.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
228 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
1514 |
Total Drug Medicare AllowedAmount |
960.5 |
Total Drug Medicare PaymentAmount |
741.86 |
Total Drug Medicare Standardized Payment Amount |
741.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
614 |
Number Of Medicare Beneficiaries With Medical Services |
157 |
Total Medical Submitted Charge Amount |
77170 |
Total Medical Medicare Allowed Amount |
38529.03 |
Total Medical Medicare Payment Amount |
29472.04 |
Total Medical Medicare Standardized Payment Amount |
29829.42 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
54 |
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 |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9155 |