National Provider Identifier [NPI]: |
1548231939 |
Last Name Of The Provider |
COFFMAN |
First Name Of The Provider |
CLIFTON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2600 GREENWOOD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711033908 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
243 |
Number Of Services |
7983 |
Number Of Medicare Beneficiaries |
4834 |
Total Submitted Charge Amount |
996278.44 |
Total Medicare Allowed Amount |
243116.25 |
Total Medicare Payment Amount |
182733.89 |
Total Medicare Standardized Payment Amount |
190419.25 |
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 |
243 |
Number Of Medical Services |
7983 |
Number Of Medicare Beneficiaries With Medical Services |
4834 |
Total Medical Submitted Charge Amount |
996278.44 |
Total Medical Medicare Allowed Amount |
243116.25 |
Total Medical Medicare Payment Amount |
182733.89 |
Total Medical Medicare Standardized Payment Amount |
190419.25 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
862 |
Number Of Beneficiaries Age 65 to 74 |
1815 |
Number Of Beneficiaries Age 75 to 84 |
1471 |
Number Of Beneficiaries Age Greater 84 |
686 |
Number Of Female Beneficiaries |
3092 |
Number Of Male Beneficiaries |
1742 |
Number Of Non Hispanic White Beneficiaries |
3460 |
Number Of Black or African American Beneficiaries |
1276 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
3523 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1311 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9259 |