| National Provider Identifier [NPI]: | 1306815600 |
| Last Name Of The Provider | COUGHLAN |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 W. HAMPDEN PL |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | ENGLEWOOD |
| Zip Code Of The Provider | 801102471 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Audiologist (billing independently) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 2561 |
| Number Of Medicare Beneficiaries | 780 |
| Total Submitted Charge Amount | 211623.5 |
| Total Medicare Allowed Amount | 94347.97 |
| Total Medicare Payment Amount | 72052.77 |
| Total Medicare Standardized Payment Amount | 69687.69 |
| 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 | 18 |
| Number Of Medical Services | 2561 |
| Number Of Medicare Beneficiaries With Medical Services | 780 |
| Total Medical Submitted Charge Amount | 211623.5 |
| Total Medical Medicare Allowed Amount | 94347.97 |
| Total Medical Medicare Payment Amount | 72052.77 |
| Total Medical Medicare Standardized Payment Amount | 69687.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 469 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 701 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 697 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9318 |