National Provider Identifier [NPI]: |
1740395623 |
Last Name Of The Provider |
COLE |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2801 FRANCISCAN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRYAN |
Zip Code Of The Provider |
778022544 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1623 |
Number Of Medicare Beneficiaries |
687 |
Total Submitted Charge Amount |
550486 |
Total Medicare Allowed Amount |
177365.71 |
Total Medicare Payment Amount |
132524.17 |
Total Medicare Standardized Payment Amount |
138466.66 |
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 |
18 |
Number Of Medical Services |
1623 |
Number Of Medicare Beneficiaries With Medical Services |
687 |
Total Medical Submitted Charge Amount |
550486 |
Total Medical Medicare Allowed Amount |
177365.71 |
Total Medical Medicare Payment Amount |
132524.17 |
Total Medical Medicare Standardized Payment Amount |
138466.66 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
229 |
Number Of Beneficiaries Age Greater 84 |
150 |
Number Of Female Beneficiaries |
363 |
Number Of Male Beneficiaries |
324 |
Number Of Non Hispanic White Beneficiaries |
474 |
Number Of Black or African American Beneficiaries |
132 |
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 |
449 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3248 |