National Provider Identifier [NPI]: |
1215926316 |
Last Name Of The Provider |
COTLIAR |
First Name Of The Provider |
ROCHELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 LACY ST NW |
Street Address 2 Of The Provider |
SUITE 150 |
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300601113 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
332 |
Number Of Medicare Beneficiaries |
157 |
Total Submitted Charge Amount |
53602 |
Total Medicare Allowed Amount |
27592.31 |
Total Medicare Payment Amount |
21631.99 |
Total Medicare Standardized Payment Amount |
21606.42 |
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 |
8 |
Number Of Medical Services |
332 |
Number Of Medicare Beneficiaries With Medical Services |
157 |
Total Medical Submitted Charge Amount |
53602 |
Total Medical Medicare Allowed Amount |
27592.31 |
Total Medical Medicare Payment Amount |
21631.99 |
Total Medical Medicare Standardized Payment Amount |
21606.42 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
129 |
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 |
134 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
41 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
|
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
54 |
Average HCC Risk Score Of Beneficiaries |
2.4287 |