| National Provider Identifier [NPI]: | 1003864703 |
| Last Name Of The Provider | COON |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4021 AVENUE B |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCOTTSBLUFF |
| Zip Code Of The Provider | 693614602 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1714 |
| Number Of Medicare Beneficiaries | 593 |
| Total Submitted Charge Amount | 292166 |
| Total Medicare Allowed Amount | 150397.8 |
| Total Medicare Payment Amount | 114256.7 |
| Total Medicare Standardized Payment Amount | 107182.58 |
| 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 | 14 |
| Number Of Medical Services | 1714 |
| Number Of Medicare Beneficiaries With Medical Services | 593 |
| Total Medical Submitted Charge Amount | 292166 |
| Total Medical Medicare Allowed Amount | 150397.8 |
| Total Medical Medicare Payment Amount | 114256.7 |
| Total Medical Medicare Standardized Payment Amount | 107182.58 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 439 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 78 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 365 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 228 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.661 |