| National Provider Identifier [NPI]: | 1568438323 |
| Last Name Of The Provider | COUGHRAN |
| First Name Of The Provider | JIMMY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 FAIR AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINNSBORO |
| Zip Code Of The Provider | 712952116 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 15125 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 729222.28 |
| Total Medicare Allowed Amount | 295804.34 |
| Total Medicare Payment Amount | 209815.76 |
| Total Medicare Standardized Payment Amount | 217473.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 8345 |
| Number Of Medicare Beneficiaries With Drug Services | 338 |
| Total Drug Submitted ChargeAmount | 93272.5 |
| Total Drug Medicare AllowedAmount | 6127.61 |
| Total Drug Medicare PaymentAmount | 4936.68 |
| Total Drug Medicare Standardized Payment Amount | 4936.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 6780 |
| Number Of Medicare Beneficiaries With Medical Services | 485 |
| Total Medical Submitted Charge Amount | 635949.78 |
| Total Medical Medicare Allowed Amount | 289676.73 |
| Total Medical Medicare Payment Amount | 204879.08 |
| Total Medical Medicare Standardized Payment Amount | 212536.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 211 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 399 |
| 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 | 325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0839 |