| National Provider Identifier [NPI]: | 1821392895 |
| Last Name Of The Provider | COULON |
| First Name Of The Provider | AIMEE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 441 WALL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRETNA |
| Zip Code Of The Provider | 700567723 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1671 |
| Number Of Medicare Beneficiaries | 157 |
| Total Submitted Charge Amount | 48085 |
| Total Medicare Allowed Amount | 22164.9 |
| Total Medicare Payment Amount | 16394.13 |
| Total Medicare Standardized Payment Amount | 19382.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1115 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 4361 |
| Total Drug Medicare AllowedAmount | 523.55 |
| Total Drug Medicare PaymentAmount | 368.01 |
| Total Drug Medicare Standardized Payment Amount | 368.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 556 |
| Number Of Medicare Beneficiaries With Medical Services | 157 |
| Total Medical Submitted Charge Amount | 43724 |
| Total Medical Medicare Allowed Amount | 21641.35 |
| Total Medical Medicare Payment Amount | 16026.12 |
| Total Medical Medicare Standardized Payment Amount | 19014.07 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | 138 |
| 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 | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9371 |