National Provider Identifier [NPI]: |
1437126075 |
Last Name Of The Provider |
COFFMAN |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
P.A.-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1416 WAINBROOK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309096289 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
992 |
Number Of Medicare Beneficiaries |
361 |
Total Submitted Charge Amount |
410083 |
Total Medicare Allowed Amount |
47284.63 |
Total Medicare Payment Amount |
36891.85 |
Total Medicare Standardized Payment Amount |
43728.74 |
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 |
48 |
Number Of Medical Services |
992 |
Number Of Medicare Beneficiaries With Medical Services |
361 |
Total Medical Submitted Charge Amount |
410083 |
Total Medical Medicare Allowed Amount |
47284.63 |
Total Medical Medicare Payment Amount |
36891.85 |
Total Medical Medicare Standardized Payment Amount |
43728.74 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
255 |
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 |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.3719 |