National Provider Identifier [NPI]: |
1013911908 |
Last Name Of The Provider |
COTTON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5610 SW LEE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAWTON |
Zip Code Of The Provider |
735059635 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
2831 |
Number Of Medicare Beneficiaries |
397 |
Total Submitted Charge Amount |
209483 |
Total Medicare Allowed Amount |
149505.35 |
Total Medicare Payment Amount |
99589.33 |
Total Medicare Standardized Payment Amount |
110249.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
277 |
Number Of Medicare Beneficiaries With Drug Services |
172 |
Total Drug Submitted ChargeAmount |
9674 |
Total Drug Medicare AllowedAmount |
5797.56 |
Total Drug Medicare PaymentAmount |
5611.19 |
Total Drug Medicare Standardized Payment Amount |
5611.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2554 |
Number Of Medicare Beneficiaries With Medical Services |
397 |
Total Medical Submitted Charge Amount |
199809 |
Total Medical Medicare Allowed Amount |
143707.79 |
Total Medical Medicare Payment Amount |
93978.14 |
Total Medical Medicare Standardized Payment Amount |
104638.06 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
54 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
320 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
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 |
1.3847 |