National Provider Identifier [NPI]: |
1215062518 |
Last Name Of The Provider |
COLLE |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1723 BROADWAY ST |
Street Address 2 Of The Provider |
SUITE 410 |
City Of The Provider |
CAPE GIRARDEAU |
Zip Code Of The Provider |
637014566 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
438 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
1711337.68 |
Total Medicare Allowed Amount |
227906.16 |
Total Medicare Payment Amount |
175510.61 |
Total Medicare Standardized Payment Amount |
177275.45 |
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 |
63 |
Number Of Medical Services |
438 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
1711337.68 |
Total Medical Medicare Allowed Amount |
227906.16 |
Total Medical Medicare Payment Amount |
175510.61 |
Total Medical Medicare Standardized Payment Amount |
177275.45 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
62 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1501 |