DR. MANOJKUMAR BUPATHI M.D.
NPI 1265675433
Internal Medicine - Hematology & Oncology in Littleton, CO

Medicare Participation & PECOS Enrollment Status

Manojkumar Bupathi is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Manojkumar Bupathi is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 7214191923

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20170616000128

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  3 DME suppliers used 16 Medicare Claims 16 Services Paid

Unknown

• Treatment-Treatment - Miscellaneous (RX029N)

  Capecitabine, oral, 500 mg (HCPCS:J8521)

  1 DME suppliers used 25 Medicare Claims 2452 Services Paid

• Treatment-Chemotherapy (RH012N)

  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)

  1 DME suppliers used 18 Medicare Claims 18 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of additional new drug or substance into vein, 1 hour or less

This procedure involves introducing a new drug or substance into your vein, typically via an IV drip. It lasts for an hour or less. This method allows the substance to quickly reach your bloodstream, ensuring rapid and effective treatment.

This service was performed 136 times for 52 patients

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 486 times for 154 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 155 times for 31 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

This service was performed 114 times for 31 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

This service was performed 67 times for 13 patients

Application of on-body injector for under skin injection

An on-body injector is a device used to deliver medication under the skin. It's applied to a clean area of skin, usually the abdomen or back of the arm. The device is activated to inject the medication slowly, ensuring a steady absorption. It's a painless, safe, and effective way to administer certain types of medication.

This service was performed 51 times for 25 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 1,503 times for 413 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 230 times for 58 patients

Carcinoembryonic antigen (cea) protein level

Carcinoembryonic Antigen (CEA) protein level is a blood test often used in cancer care. It measures the amount of CEA protein in your blood, which can increase in cases of certain types of cancer. It's used to monitor treatment progress and check for cancer recurrence.

This service was performed 591 times for 258 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

This service was performed 41 times for 25 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 1,929 times for 467 patients

Ct scan of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

This service was performed 11 times for 11 patients

Ct scan of chest with contrast

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

This service was performed 16 times for 15 patients

Cyclophosphamide, 100 mg

Cyclophosphamide is a medication used in treating various types of cancers and certain immune system diseases. It works by interfering with the growth of cancer cells, which are then destroyed by the body. The 100 mg dosage refers to the amount of medication in each dose.

This service was performed 264 times for 13 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 576 times for 368 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 716 times for 286 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 156 times for 95 patients

Ferritin (blood protein) level

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

This service was performed 63 times for 40 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 42 times for 28 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 14 times for 13 patients

Immunologic analysis for detection of tumor antigen, quantitative; ca 125

This test checks for CA 125, a protein often found in higher amounts in individuals with certain types of tumors. It involves analyzing a blood sample in a lab. It's a quantitative test, meaning it measures the level of CA 125 in your blood.

This service was performed 56 times for 12 patients

Immunologic analysis for detection of tumor antigen, quantitative; ca 15-3

This is a blood test that measures the level of CA 15-3, a protein often higher in individuals with certain types of cancer. It helps monitor response to treatment and check for cancer recurrence. It's not a standalone diagnostic test but used alongside other evaluations.

This service was performed 595 times for 253 patients

Infusion into a vein for hydration, 31-60 minutes

This is a procedure where a sterile solution is administered into your vein to help restore body fluid balance. It typically lasts between 31-60 minutes. It's a safe, common treatment for dehydration or to deliver medication.

This service was performed 81 times for 51 patients

Infusion into a vein for hydration, each additional hour

This procedure involves delivering fluids directly into your vein to keep your body hydrated. It is typically done when oral hydration is insufficient. Each additional hour means more fluid is infused to ensure adequate hydration.

This service was performed 17 times for 14 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 168 times for 95 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

This service was performed 201 times for 77 patients

Infusion into a vein for therapy, prevention, or diagnosis, each additional hour

This procedure involves delivering medication, fluids, or nutrients directly into your vein. This is done to treat, prevent, or diagnose various conditions. Each additional hour refers to the extended time you may need to receive these substances for optimal results.

This service was performed 139 times for 33 patients

Infusion, normal saline solution , 1000 cc

An infusion of normal saline solution, 1000 cc, is a common medical procedure. It involves introducing a saltwater solution into your bloodstream via an intravenous (IV) line. This helps to hydrate your body, correct electrolyte imbalances, and deliver medications if needed.

This service was performed 97 times for 57 patients

Injection of additional new drug or substance into vein

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

This service was performed 395 times for 106 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 177 times for 70 patients

Injection, carboplatin, 50 mg

Carboplatin is a chemotherapy drug used to treat various types of cancer by slowing or stopping the growth of cancer cells. The 50 mg injection is administered into a vein by a healthcare professional. Side effects may occur.

This service was performed 343 times for 22 patients

Injection, darbepoetin alfa, 1 microgram (non-esrd use)

Darbepoetin alfa injection is a medication used to treat anemia (low red blood cell count) often caused by chronic kidney disease or chemotherapy. It works by stimulating your body to produce more red blood cells, helping to increase your energy and well-being.

This service was performed 8,980 times for 11 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 1,860 times for 16 patients

Injection, dexamethasone sodium phosphate, 1 mg

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

This service was performed 2,527 times for 90 patients

Injection, diphenhydramine hcl, up to 50 mg

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

This service was performed 142 times for 52 patients

Injection, docetaxel, 1 mg

Docetaxel is a medication given via injection to treat various types of cancer. It works by stopping cancer cells from growing and dividing. Each injection contains 1 mg of docetaxel. Side effects can occur, so regular monitoring is essential.

This service was performed 7,830 times for 23 patients

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)

Ferumoxytol injection is a treatment for iron deficiency anemia, a condition where your body lacks enough iron. It is injected into your vein to increase iron levels, aiding in the production of healthy red blood cells. This treatment is not for ESRD patients.

This service was performed 14,790 times for 20 patients

Injection, fosaprepitant, 1 mg

Fosaprepitant is an anti-nausea medication given via injection. It's often used to prevent nausea and vomiting caused by chemotherapy. This injection blocks signals to the brain that trigger these symptoms, helping you feel better.

This service was performed 9,300 times for 29 patients

Injection, fulvestrant, 25 mg

Fulvestrant is an injectable medication used to manage certain types of conditions. It works by blocking the effect of a natural substance in your body. The 25 mg dosage refers to the amount of active substance in each injection.

This service was performed 840 times for 13 patients

Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg

Gemcitabine hydrochloride is a medication given via injection to treat certain types of cancer. The 200 mg dose is administered by a healthcare professional. The drug works by slowing or stopping the growth of cancer cells in the body. It's important to follow your doctor's instructions while receiving this treatment.

This service was performed 379 times for 11 patients

Injection, granisetron hydrochloride, 100 mcg

Granisetron hydrochloride is an anti-nausea medication given by injection. It helps prevent nausea and vomiting often caused by cancer treatments like chemotherapy. Its dosage is measured in micrograms (mcg).

This service was performed 1,040 times for 42 patients

Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg

This procedure involves an intravenous injection of Octagam, a liquid immune globulin. It is a blood product that helps your body fight off infections. It's given through a vein (IV) and each dose contains 500 mg of the medication.

This service was performed 3,010 times for 11 patients

Injection, iron sucrose, 1 mg

Iron sucrose injection is a treatment given to replenish iron in your body, often used when oral iron supplements are not effective. This helps your body make red blood cells, improving health and energy levels.

This service was performed 9,600 times for 27 patients

Injection, magnesium sulfate, per 500 mg

Magnesium sulfate injection, per 500 mg, is a medication administered to manage certain health conditions. It aids in controlling seizures in conditions like eclampsia and in managing severe asthma attacks. It's also used to prevent premature labor in pregnant women.

This service was performed 172 times for 20 patients

Injection, paclitaxel, 1 mg

Paclitaxel is a medication administered via injection to treat various types of cancer. It works by inhibiting cell division, thus preventing cancer cells from growing and multiplying. Each dose is tailored to the patient's body size.

This service was performed 6,300 times for 13 patients

Injection, palonosetron hcl, 25 mcg

Palonosetron HCL is an injection used to prevent nausea and vomiting caused by chemotherapy. It works by blocking a natural substance (serotonin) in the body that can cause vomiting. This helps improve your comfort during cancer treatment.

This service was performed 1,170 times for 49 patients

Injection, pegfilgrastim, excludes biosimilar, 0.5 mg

Pegfilgrastim is a medication given via injection to stimulate the production of white blood cells. It's used to prevent infections after chemotherapy. This specific dose is 0.5 mg, and it's not a biosimilar, meaning it's the original, not a copy.

This service was performed 636 times for 27 patients

Injection, pembrolizumab, 1 mg

Pembrolizumab is a medication given via injection to help your body's immune system fight certain types of cancer. It's typically administered in a hospital or clinic by a healthcare professional.

This service was performed 16,400 times for 25 patients

Injection, potassium chloride, per 2 meq

Potassium chloride injection is a treatment to replenish low potassium levels in your body. Each 2 meq dose helps maintain heart function and fluid balance. It's administered by a healthcare professional, usually into a vein.

This service was performed 315 times for 12 patients

Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromise

Tixagevimab and cilgavimab injection is a preventive treatment for certain adults and children (12+ years, weighing 40kg+) with compromised health conditions. It's used when there's no known exposure to SARS-CoV-2, to help their bodies better fend off potential infections.

This service was performed 17 times for 17 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

This service was performed 24 times for 11 patients

Injection, zoledronic acid, 1 mg

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

This service was performed 150 times for 27 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 1,813 times for 498 patients

Iron binding capacity

Iron binding capacity is a blood test that measures how well your body can bind and transport iron. This helps your healthcare provider assess if your body has too little or too much iron, which can indicate certain health conditions.

This service was performed 21 times for 16 patients

Iron level

An iron level test measures the amount of iron in your blood. Iron is crucial for producing hemoglobin, a protein in red blood cells that carries oxygen throughout your body. This test helps identify iron deficiencies or excesses, which can lead to conditions like anemia or hemochromatosis.

This service was performed 21 times for 16 patients

Irrigation of implanted venous access drug delivery device

Irrigation of an implanted venous access drug delivery device is a procedure to clean or unblock the device. This device is implanted under your skin to allow easy, frequent, and long-term access to your veins for medication delivery. The process involves flushing the device with a sterile solution to ensure it works properly.

This service was performed 21 times for 13 patients

Lactate dehydrogenase (enzyme) level

A Lactate Dehydrogenase level test measures the amount of this enzyme in your body. It's often done when tissue damage is suspected, as high levels can indicate issues like heart disease, lung disease, liver disease, or blood disorders. This test helps in diagnosing and monitoring these conditions.

This service was performed 106 times for 39 patients

Leuprolide acetate (for depot suspension), 7.5 mg

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

This service was performed 91 times for 18 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 1,490 times for 16 patients

Magnesium level

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

This service was performed 188 times for 71 patients

Microscopic examination for white blood cells with manual cell count

This is a lab test where a small sample of your blood is studied under a microscope. The goal is to count the number of white blood cells, which are crucial for your body's immune response. The count can help identify potential health issues.

This service was performed 19 times for 11 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 83 times for 83 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 49 times for 49 patients

Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a

The Oncology Care Model (OCM) Monthly Enhanced Oncology Services (MEOS) payment, denoted by G9678, is a compensation method for OCM practitioners. These payments are specifically for providing additional, or "enhanced", services to OCM beneficiaries, as outlined in the OCM participation agreement.

This service was performed 354 times for 106 patients

Phosphate level

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

This service was performed 30 times for 13 patients

Psa (prostate specific antigen) measurement, total

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

This service was performed 375 times for 78 patients

Reticulated (young) platelet measurement

Reticulated (young) platelet measurement is a blood test that helps determine the number of new platelets your body is producing. It's useful for diagnosing and monitoring conditions affecting platelet production, like anemia or chemotherapy effects.

This service was performed 21 times for 15 patients

Unclassified drugs

Unclassified drugs are medications that don't fit into an existing category or class due to their unique properties or uses. They may be used for various conditions and their effects may differ widely. Always ask your healthcare provider for more information about these drugs.

This service was performed 127 times for 35 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 61 times for 28 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $43.7 for a new patient copayment and $25.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 80120 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 84.8, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: .

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 84.8 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: 66.45

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: 100

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: 40

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

MIPS Quality Measures

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