National Provider Identifier [NPI]: |
1750360327 |
Last Name Of The Provider |
COLEMAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13131 TESSON FERRY RD |
Street Address 2 Of The Provider |
SUITE #105 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631283887 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
15978 |
Number Of Medicare Beneficiaries |
700 |
Total Submitted Charge Amount |
2379743.48 |
Total Medicare Allowed Amount |
745469.33 |
Total Medicare Payment Amount |
545460.71 |
Total Medicare Standardized Payment Amount |
507902.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
10859 |
Number Of Medicare Beneficiaries With Drug Services |
493 |
Total Drug Submitted ChargeAmount |
45984.11 |
Total Drug Medicare AllowedAmount |
9084.68 |
Total Drug Medicare PaymentAmount |
6878.93 |
Total Drug Medicare Standardized Payment Amount |
6878.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
5119 |
Number Of Medicare Beneficiaries With Medical Services |
700 |
Total Medical Submitted Charge Amount |
2333759.37 |
Total Medical Medicare Allowed Amount |
736384.65 |
Total Medical Medicare Payment Amount |
538581.78 |
Total Medical Medicare Standardized Payment Amount |
501023.72 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
314 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
439 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
681 |
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 |
575 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3093 |