National Provider Identifier [NPI]: |
1679574230 |
Last Name Of The Provider |
COUTIN |
First Name Of The Provider |
RAFAEL |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1521 S STAPLES ST |
Street Address 2 Of The Provider |
SUITE 700 |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784043150 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1123 |
Number Of Medicare Beneficiaries |
584 |
Total Submitted Charge Amount |
156932 |
Total Medicare Allowed Amount |
68652.62 |
Total Medicare Payment Amount |
50135.89 |
Total Medicare Standardized Payment Amount |
53076.08 |
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 |
30 |
Number Of Medical Services |
1123 |
Number Of Medicare Beneficiaries With Medical Services |
584 |
Total Medical Submitted Charge Amount |
156932 |
Total Medical Medicare Allowed Amount |
68652.62 |
Total Medical Medicare Payment Amount |
50135.89 |
Total Medical Medicare Standardized Payment Amount |
53076.08 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
267 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
409 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
175 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.3339 |