National Provider Identifier [NPI]: |
1023150422 |
Last Name Of The Provider |
COLEMAN |
First Name Of The Provider |
ANGELA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1035 RED BUD RD NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CALHOUN |
Zip Code Of The Provider |
307016010 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
613 |
Number Of Medicare Beneficiaries |
504 |
Total Submitted Charge Amount |
615107 |
Total Medicare Allowed Amount |
90466.83 |
Total Medicare Payment Amount |
70080.59 |
Total Medicare Standardized Payment Amount |
71689.8 |
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 |
21 |
Number Of Medical Services |
613 |
Number Of Medicare Beneficiaries With Medical Services |
504 |
Total Medical Submitted Charge Amount |
615107 |
Total Medical Medicare Allowed Amount |
90466.83 |
Total Medical Medicare Payment Amount |
70080.59 |
Total Medical Medicare Standardized Payment Amount |
71689.8 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
153 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
293 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
431 |
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 |
294 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
210 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1375 |