National Provider Identifier [NPI]: |
1457586885 |
Last Name Of The Provider |
ALLEN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1011 14TH AVE NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARDMORE |
Zip Code Of The Provider |
734011828 |
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 |
32 |
Number Of Services |
1868 |
Number Of Medicare Beneficiaries |
659 |
Total Submitted Charge Amount |
264189 |
Total Medicare Allowed Amount |
156445.12 |
Total Medicare Payment Amount |
119372.75 |
Total Medicare Standardized Payment Amount |
125817.44 |
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 |
32 |
Number Of Medical Services |
1868 |
Number Of Medicare Beneficiaries With Medical Services |
659 |
Total Medical Submitted Charge Amount |
264189 |
Total Medical Medicare Allowed Amount |
156445.12 |
Total Medical Medicare Payment Amount |
119372.75 |
Total Medical Medicare Standardized Payment Amount |
125817.44 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
368 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
559 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
50 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
455 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
204 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3864 |