National Provider Identifier [NPI]: |
1902879976 |
Last Name Of The Provider |
COCHRAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3000 MACK RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
FAIRFIELD |
Zip Code Of The Provider |
450145335 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Peripheral Vascular Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
1639 |
Number Of Medicare Beneficiaries |
962 |
Total Submitted Charge Amount |
246447 |
Total Medicare Allowed Amount |
155582.62 |
Total Medicare Payment Amount |
114267.26 |
Total Medicare Standardized Payment Amount |
118436.28 |
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 |
63 |
Number Of Medical Services |
1639 |
Number Of Medicare Beneficiaries With Medical Services |
962 |
Total Medical Submitted Charge Amount |
246447 |
Total Medical Medicare Allowed Amount |
155582.62 |
Total Medical Medicare Payment Amount |
114267.26 |
Total Medical Medicare Standardized Payment Amount |
118436.28 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
173 |
Number Of Beneficiaries Age 65 to 74 |
344 |
Number Of Beneficiaries Age 75 to 84 |
286 |
Number Of Beneficiaries Age Greater 84 |
159 |
Number Of Female Beneficiaries |
491 |
Number Of Male Beneficiaries |
471 |
Number Of Non Hispanic White Beneficiaries |
815 |
Number Of Black or African American Beneficiaries |
120 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
755 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9238 |