National Provider Identifier [NPI]: |
1467412353 |
Last Name Of The Provider |
COYLE |
First Name Of The Provider |
YVONNE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1643 LANCASTER DR |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
GRAPEVINE |
Zip Code Of The Provider |
760513593 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
10353 |
Number Of Medicare Beneficiaries |
126 |
Total Submitted Charge Amount |
725751 |
Total Medicare Allowed Amount |
217910.94 |
Total Medicare Payment Amount |
170860.22 |
Total Medicare Standardized Payment Amount |
171733.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
31 |
Number Of Drug Services |
8823 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
420251 |
Total Drug Medicare AllowedAmount |
121282.51 |
Total Drug Medicare PaymentAmount |
95091.3 |
Total Drug Medicare Standardized Payment Amount |
95091.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
1530 |
Number Of Medicare Beneficiaries With Medical Services |
126 |
Total Medical Submitted Charge Amount |
305500 |
Total Medical Medicare Allowed Amount |
96628.43 |
Total Medical Medicare Payment Amount |
75768.92 |
Total Medical Medicare Standardized Payment Amount |
76642.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
100 |
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 |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
|
Percent Of With Cancer |
52 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2036 |