National Provider Identifier [NPI]: |
1396710497 |
Last Name Of The Provider |
COLWELL |
First Name Of The Provider |
RICK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2501 PIERCE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SIOUX CITY |
Zip Code Of The Provider |
511043725 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
510 |
Total Submitted Charge Amount |
173548 |
Total Medicare Allowed Amount |
80583.08 |
Total Medicare Payment Amount |
59093.27 |
Total Medicare Standardized Payment Amount |
62785.34 |
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 |
19 |
Number Of Medical Services |
586 |
Number Of Medicare Beneficiaries With Medical Services |
510 |
Total Medical Submitted Charge Amount |
173548 |
Total Medical Medicare Allowed Amount |
80583.08 |
Total Medical Medicare Payment Amount |
59093.27 |
Total Medical Medicare Standardized Payment Amount |
62785.34 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
305 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
463 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7744 |