National Provider Identifier [NPI]: |
1215956024 |
Last Name Of The Provider |
COONS |
First Name Of The Provider |
DAVID |
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 |
3124 S 19TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984052433 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
2788 |
Number Of Medicare Beneficiaries |
435 |
Total Submitted Charge Amount |
649585.5 |
Total Medicare Allowed Amount |
214011.02 |
Total Medicare Payment Amount |
161807.94 |
Total Medicare Standardized Payment Amount |
162570.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1368 |
Number Of Medicare Beneficiaries With Drug Services |
218 |
Total Drug Submitted ChargeAmount |
5336 |
Total Drug Medicare AllowedAmount |
2282.7 |
Total Drug Medicare PaymentAmount |
1692.8 |
Total Drug Medicare Standardized Payment Amount |
1692.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
1420 |
Number Of Medicare Beneficiaries With Medical Services |
435 |
Total Medical Submitted Charge Amount |
644249.5 |
Total Medical Medicare Allowed Amount |
211728.32 |
Total Medical Medicare Payment Amount |
160115.14 |
Total Medical Medicare Standardized Payment Amount |
160877.26 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
176 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
283 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
354 |
Number Of Black or African American Beneficiaries |
40 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
330 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.117 |