National Provider Identifier [NPI]: |
1801889845 |
Last Name Of The Provider |
COLEMAN |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1265 S UTICA AVE |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741044243 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
434 |
Number Of Medicare Beneficiaries |
160 |
Total Submitted Charge Amount |
405088 |
Total Medicare Allowed Amount |
173680.74 |
Total Medicare Payment Amount |
134875.5 |
Total Medicare Standardized Payment Amount |
144808.44 |
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 |
51 |
Number Of Medical Services |
434 |
Number Of Medicare Beneficiaries With Medical Services |
160 |
Total Medical Submitted Charge Amount |
405088 |
Total Medical Medicare Allowed Amount |
173680.74 |
Total Medical Medicare Payment Amount |
134875.5 |
Total Medical Medicare Standardized Payment Amount |
144808.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
124 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
19 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
107 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.5339 |