| National Provider Identifier [NPI]: | 1861451411 |
| Last Name Of The Provider | WOOLLEY |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2490 W 26TH AVE |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | DENVER |
| Zip Code Of The Provider | 802115314 |
| 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 | 207 |
| Number Of Services | 8346 |
| Number Of Medicare Beneficiaries | 3614 |
| Total Submitted Charge Amount | 1037101.79 |
| Total Medicare Allowed Amount | 265760.71 |
| Total Medicare Payment Amount | 204484.41 |
| Total Medicare Standardized Payment Amount | 208509.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3064 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 4259.79 |
| Total Drug Medicare AllowedAmount | 1751.11 |
| Total Drug Medicare PaymentAmount | 1358.38 |
| Total Drug Medicare Standardized Payment Amount | 1358.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 202 |
| Number Of Medical Services | 5282 |
| Number Of Medicare Beneficiaries With Medical Services | 3613 |
| Total Medical Submitted Charge Amount | 1032842 |
| Total Medical Medicare Allowed Amount | 264009.6 |
| Total Medical Medicare Payment Amount | 203126.03 |
| Total Medical Medicare Standardized Payment Amount | 207150.81 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 721 |
| Number Of Beneficiaries Age 65 to 74 | 1432 |
| Number Of Beneficiaries Age 75 to 84 | 947 |
| Number Of Beneficiaries Age Greater 84 | 514 |
| Number Of Female Beneficiaries | 2164 |
| Number Of Male Beneficiaries | 1450 |
| Number Of Non Hispanic White Beneficiaries | 2957 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 80 |
| Number Of Hispanic Beneficiaries | 458 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | 64 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2791 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 823 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5606 |