National Provider Identifier [NPI]: |
1578563672 |
Last Name Of The Provider |
HERNDON |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2515 W ELK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DUNCAN |
Zip Code Of The Provider |
735331571 |
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 |
87 |
Number Of Services |
6767 |
Number Of Medicare Beneficiaries |
641 |
Total Submitted Charge Amount |
424187 |
Total Medicare Allowed Amount |
292899.87 |
Total Medicare Payment Amount |
213556.22 |
Total Medicare Standardized Payment Amount |
234302.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
581 |
Number Of Medicare Beneficiaries With Drug Services |
228 |
Total Drug Submitted ChargeAmount |
11190 |
Total Drug Medicare AllowedAmount |
6311.92 |
Total Drug Medicare PaymentAmount |
5869.26 |
Total Drug Medicare Standardized Payment Amount |
5869.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
6186 |
Number Of Medicare Beneficiaries With Medical Services |
641 |
Total Medical Submitted Charge Amount |
412997 |
Total Medical Medicare Allowed Amount |
286587.95 |
Total Medical Medicare Payment Amount |
207686.96 |
Total Medical Medicare Standardized Payment Amount |
228433.28 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
266 |
Number Of Beneficiaries Age 75 to 84 |
200 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
355 |
Number Of Male Beneficiaries |
286 |
Number Of Non Hispanic White Beneficiaries |
589 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
23 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
546 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.946 |