National Provider Identifier [NPI]: |
1962558957 |
Last Name Of The Provider |
OKINE |
First Name Of The Provider |
ALBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C., M.S.P.A.S. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3549 SOUTHERN HILLS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SIOUX CITY |
Zip Code Of The Provider |
511064736 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
76764 |
Total Medicare Allowed Amount |
41493.38 |
Total Medicare Payment Amount |
30630.09 |
Total Medicare Standardized Payment Amount |
38012.06 |
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 |
20 |
Number Of Medical Services |
589 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
76764 |
Total Medical Medicare Allowed Amount |
41493.38 |
Total Medical Medicare Payment Amount |
30630.09 |
Total Medical Medicare Standardized Payment Amount |
38012.06 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
181 |
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 |
57 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
73 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
40 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5977 |