National Provider Identifier [NPI]: |
1245498781 |
Last Name Of The Provider |
MEKETE |
First Name Of The Provider |
BAHIRU |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2220 W IOWA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICKASHA |
Zip Code Of The Provider |
730182738 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1970 |
Number Of Medicare Beneficiaries |
823 |
Total Submitted Charge Amount |
283669 |
Total Medicare Allowed Amount |
150127.64 |
Total Medicare Payment Amount |
112395.86 |
Total Medicare Standardized Payment Amount |
118739.59 |
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 |
23 |
Number Of Medical Services |
1970 |
Number Of Medicare Beneficiaries With Medical Services |
823 |
Total Medical Submitted Charge Amount |
283669 |
Total Medical Medicare Allowed Amount |
150127.64 |
Total Medical Medicare Payment Amount |
112395.86 |
Total Medical Medicare Standardized Payment Amount |
118739.59 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
159 |
Number Of Beneficiaries Age 65 to 74 |
271 |
Number Of Beneficiaries Age 75 to 84 |
248 |
Number Of Beneficiaries Age Greater 84 |
145 |
Number Of Female Beneficiaries |
461 |
Number Of Male Beneficiaries |
362 |
Number Of Non Hispanic White Beneficiaries |
667 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
68 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
557 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
266 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0094 |