| National Provider Identifier [NPI]: | 1679571582 |
| Last Name Of The Provider | COFFEY |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 E ROBINSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORMAN |
| Zip Code Of The Provider | 730716610 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 12056.5 |
| Number Of Medicare Beneficiaries | 954 |
| Total Submitted Charge Amount | 1399485.15 |
| Total Medicare Allowed Amount | 295510.24 |
| Total Medicare Payment Amount | 222788.47 |
| Total Medicare Standardized Payment Amount | 257529.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 10883.5 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 9795.15 |
| Total Drug Medicare AllowedAmount | 4450.98 |
| Total Drug Medicare PaymentAmount | 3380.32 |
| Total Drug Medicare Standardized Payment Amount | 3380.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1173 |
| Number Of Medicare Beneficiaries With Medical Services | 953 |
| Total Medical Submitted Charge Amount | 1389690 |
| Total Medical Medicare Allowed Amount | 291059.26 |
| Total Medical Medicare Payment Amount | 219408.15 |
| Total Medical Medicare Standardized Payment Amount | 254149.23 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 152 |
| Number Of Beneficiaries Age 65 to 74 | 471 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 621 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 34 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 823 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0062 |