National Provider Identifier [NPI]: |
1023095262 |
Last Name Of The Provider |
CORDTS |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
515 READ ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVANSVILLE |
Zip Code Of The Provider |
477101739 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
387 |
Number Of Medicare Beneficiaries |
97 |
Total Submitted Charge Amount |
58327 |
Total Medicare Allowed Amount |
28728.56 |
Total Medicare Payment Amount |
21761.26 |
Total Medicare Standardized Payment Amount |
22999.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1153 |
Total Drug Medicare AllowedAmount |
522.2 |
Total Drug Medicare PaymentAmount |
494 |
Total Drug Medicare Standardized Payment Amount |
494 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
342 |
Number Of Medicare Beneficiaries With Medical Services |
97 |
Total Medical Submitted Charge Amount |
57174 |
Total Medical Medicare Allowed Amount |
28206.36 |
Total Medical Medicare Payment Amount |
21267.26 |
Total Medical Medicare Standardized Payment Amount |
22505.01 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
50 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6464 |