National Provider Identifier [NPI]: |
1487635066 |
Last Name Of The Provider |
COATES |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4450 SUNSET DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANGELO |
Zip Code Of The Provider |
76904 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
163 |
Number Of Services |
5917 |
Number Of Medicare Beneficiaries |
978 |
Total Submitted Charge Amount |
613331.06 |
Total Medicare Allowed Amount |
314542.51 |
Total Medicare Payment Amount |
246085.98 |
Total Medicare Standardized Payment Amount |
255452.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
1812 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
735.76 |
Total Drug Medicare AllowedAmount |
730.6 |
Total Drug Medicare PaymentAmount |
654.79 |
Total Drug Medicare Standardized Payment Amount |
654.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
160 |
Number Of Medical Services |
4105 |
Number Of Medicare Beneficiaries With Medical Services |
978 |
Total Medical Submitted Charge Amount |
612595.3 |
Total Medical Medicare Allowed Amount |
313811.91 |
Total Medical Medicare Payment Amount |
245431.19 |
Total Medical Medicare Standardized Payment Amount |
254797.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
414 |
Number Of Beneficiaries Age 75 to 84 |
307 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
569 |
Number Of Male Beneficiaries |
409 |
Number Of Non Hispanic White Beneficiaries |
738 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
209 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
795 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3162 |