National Provider Identifier [NPI]: |
1083943260 |
Last Name Of The Provider |
COEN |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
399 E 21ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN BERNARDINO |
Zip Code Of The Provider |
924044815 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
146 |
Number Of Services |
6186 |
Number Of Medicare Beneficiaries |
1064 |
Total Submitted Charge Amount |
1157960.61 |
Total Medicare Allowed Amount |
264813.53 |
Total Medicare Payment Amount |
206089.36 |
Total Medicare Standardized Payment Amount |
195155.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
4482 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
12562 |
Total Drug Medicare AllowedAmount |
1846.54 |
Total Drug Medicare PaymentAmount |
1447.69 |
Total Drug Medicare Standardized Payment Amount |
1447.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
142 |
Number Of Medical Services |
1704 |
Number Of Medicare Beneficiaries With Medical Services |
1064 |
Total Medical Submitted Charge Amount |
1145398.61 |
Total Medical Medicare Allowed Amount |
262966.99 |
Total Medical Medicare Payment Amount |
204641.67 |
Total Medical Medicare Standardized Payment Amount |
193707.49 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
263 |
Number Of Beneficiaries Age 65 to 74 |
457 |
Number Of Beneficiaries Age 75 to 84 |
253 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
687 |
Number Of Male Beneficiaries |
377 |
Number Of Non Hispanic White Beneficiaries |
490 |
Number Of Black or African American Beneficiaries |
120 |
Number Of AsianPacific Islander Beneficiaries |
89 |
Number Of Hispanic Beneficiaries |
345 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
443 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
621 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.347 |