National Provider Identifier [NPI]: |
1629063409 |
Last Name Of The Provider |
ANDREWS |
First Name Of The Provider |
ANDREA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1102 W MACARTHUR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHAWNEE |
Zip Code Of The Provider |
748041743 |
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 |
19 |
Number Of Services |
812 |
Number Of Medicare Beneficiaries |
708 |
Total Submitted Charge Amount |
646553 |
Total Medicare Allowed Amount |
115377.12 |
Total Medicare Payment Amount |
90041.03 |
Total Medicare Standardized Payment Amount |
93594.03 |
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 |
19 |
Number Of Medical Services |
812 |
Number Of Medicare Beneficiaries With Medical Services |
708 |
Total Medical Submitted Charge Amount |
646553 |
Total Medical Medicare Allowed Amount |
115377.12 |
Total Medical Medicare Payment Amount |
90041.03 |
Total Medical Medicare Standardized Payment Amount |
93594.03 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
155 |
Number Of Beneficiaries Age 65 to 74 |
178 |
Number Of Beneficiaries Age 75 to 84 |
200 |
Number Of Beneficiaries Age Greater 84 |
175 |
Number Of Female Beneficiaries |
460 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
575 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
28 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8309 |