National Provider Identifier [NPI]: |
1972507705 |
Last Name Of The Provider |
COATS |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4600 MEMORIAL DR |
Street Address 2 Of The Provider |
STE. 240 |
City Of The Provider |
BELLEVILLE |
Zip Code Of The Provider |
622265368 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
129 |
Number Of Services |
1977 |
Number Of Medicare Beneficiaries |
589 |
Total Submitted Charge Amount |
772677.03 |
Total Medicare Allowed Amount |
263575.57 |
Total Medicare Payment Amount |
202144.79 |
Total Medicare Standardized Payment Amount |
190545.21 |
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 |
129 |
Number Of Medical Services |
1977 |
Number Of Medicare Beneficiaries With Medical Services |
589 |
Total Medical Submitted Charge Amount |
772677.03 |
Total Medical Medicare Allowed Amount |
263575.57 |
Total Medical Medicare Payment Amount |
202144.79 |
Total Medical Medicare Standardized Payment Amount |
190545.21 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
293 |
Number Of Non Hispanic White Beneficiaries |
462 |
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 |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
158 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.399 |