National Provider Identifier [NPI]: |
1679885990 |
Last Name Of The Provider |
COOLMAN |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 N CAMPBELL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857245011 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1031 |
Number Of Medicare Beneficiaries |
708 |
Total Submitted Charge Amount |
954909 |
Total Medicare Allowed Amount |
133287.91 |
Total Medicare Payment Amount |
103343.97 |
Total Medicare Standardized Payment Amount |
97804.49 |
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 |
28 |
Number Of Medical Services |
1031 |
Number Of Medicare Beneficiaries With Medical Services |
708 |
Total Medical Submitted Charge Amount |
954909 |
Total Medical Medicare Allowed Amount |
133287.91 |
Total Medical Medicare Payment Amount |
103343.97 |
Total Medical Medicare Standardized Payment Amount |
97804.49 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
190 |
Number Of Beneficiaries Age Greater 84 |
204 |
Number Of Female Beneficiaries |
418 |
Number Of Male Beneficiaries |
290 |
Number Of Non Hispanic White Beneficiaries |
547 |
Number Of Black or African American Beneficiaries |
110 |
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 |
466 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
242 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.2258 |