National Provider Identifier [NPI]: |
1811983539 |
Last Name Of The Provider |
COYLE |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3200 PROVIDENCE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANCHORAGE |
Zip Code Of The Provider |
995084661 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
250 |
Number Of Services |
8340 |
Number Of Medicare Beneficiaries |
2231 |
Total Submitted Charge Amount |
1248401 |
Total Medicare Allowed Amount |
300329.4 |
Total Medicare Payment Amount |
228581.23 |
Total Medicare Standardized Payment Amount |
179202.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
4226 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
4238 |
Total Drug Medicare AllowedAmount |
924.48 |
Total Drug Medicare PaymentAmount |
699.38 |
Total Drug Medicare Standardized Payment Amount |
699.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
247 |
Number Of Medical Services |
4114 |
Number Of Medicare Beneficiaries With Medical Services |
2231 |
Total Medical Submitted Charge Amount |
1244163 |
Total Medical Medicare Allowed Amount |
299404.92 |
Total Medical Medicare Payment Amount |
227881.85 |
Total Medical Medicare Standardized Payment Amount |
178502.66 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
459 |
Number Of Beneficiaries Age 65 to 74 |
878 |
Number Of Beneficiaries Age 75 to 84 |
623 |
Number Of Beneficiaries Age Greater 84 |
271 |
Number Of Female Beneficiaries |
1258 |
Number Of Male Beneficiaries |
973 |
Number Of Non Hispanic White Beneficiaries |
1684 |
Number Of Black or African American Beneficiaries |
112 |
Number Of AsianPacific Islander Beneficiaries |
197 |
Number Of Hispanic Beneficiaries |
92 |
Number Of American Indian Alaska Native Beneficiaries |
101 |
Number Of Beneficiaries With Race Not Else where Classified |
45 |
Number Of Beneficiaries With Medicare Only Entitlement |
1371 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
860 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8882 |