| National Provider Identifier [NPI]: | 1902853435 |
| Last Name Of The Provider | COULAM |
| First Name Of The Provider | CURTIS |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N CURTIS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061309 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 9951 |
| Number Of Medicare Beneficiaries | 2437 |
| Total Submitted Charge Amount | 414830.3 |
| Total Medicare Allowed Amount | 187173.14 |
| Total Medicare Payment Amount | 136418.13 |
| Total Medicare Standardized Payment Amount | 147741.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 6504 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 2138.92 |
| Total Drug Medicare AllowedAmount | 2075.24 |
| Total Drug Medicare PaymentAmount | 1597.35 |
| Total Drug Medicare Standardized Payment Amount | 1597.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 187 |
| Number Of Medical Services | 3447 |
| Number Of Medicare Beneficiaries With Medical Services | 2437 |
| Total Medical Submitted Charge Amount | 412691.38 |
| Total Medical Medicare Allowed Amount | 185097.9 |
| Total Medical Medicare Payment Amount | 134820.78 |
| Total Medical Medicare Standardized Payment Amount | 146144.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 541 |
| Number Of Beneficiaries Age 65 to 74 | 816 |
| Number Of Beneficiaries Age 75 to 84 | 711 |
| Number Of Beneficiaries Age Greater 84 | 369 |
| Number Of Female Beneficiaries | 1326 |
| Number Of Male Beneficiaries | 1111 |
| Number Of Non Hispanic White Beneficiaries | 2198 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 149 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1641 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 796 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6587 |