National Provider Identifier [NPI]: |
1205886389 |
Last Name Of The Provider |
COTTER |
First Name Of The Provider |
BRUNO |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 W ARBOR DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921039000 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1627 |
Number Of Medicare Beneficiaries |
863 |
Total Submitted Charge Amount |
551373 |
Total Medicare Allowed Amount |
130052.69 |
Total Medicare Payment Amount |
96027.42 |
Total Medicare Standardized Payment Amount |
94063.88 |
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 |
34 |
Number Of Medical Services |
1627 |
Number Of Medicare Beneficiaries With Medical Services |
863 |
Total Medical Submitted Charge Amount |
551373 |
Total Medical Medicare Allowed Amount |
130052.69 |
Total Medical Medicare Payment Amount |
96027.42 |
Total Medical Medicare Standardized Payment Amount |
94063.88 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
186 |
Number Of Beneficiaries Age 65 to 74 |
345 |
Number Of Beneficiaries Age 75 to 84 |
221 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
391 |
Number Of Male Beneficiaries |
472 |
Number Of Non Hispanic White Beneficiaries |
518 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
90 |
Number Of Hispanic Beneficiaries |
148 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
489 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
374 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1507 |