National Provider Identifier [NPI]: |
1225079494 |
Last Name Of The Provider |
MAURY |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5604 SW LEE BLVD |
Street Address 2 Of The Provider |
SUITE 245 |
City Of The Provider |
LAWTON |
Zip Code Of The Provider |
735059681 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
10151 |
Number Of Medicare Beneficiaries |
990 |
Total Submitted Charge Amount |
1037625.2 |
Total Medicare Allowed Amount |
380639.67 |
Total Medicare Payment Amount |
270745.33 |
Total Medicare Standardized Payment Amount |
283815.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
348 |
Number Of Medicare Beneficiaries With Drug Services |
162 |
Total Drug Submitted ChargeAmount |
9742 |
Total Drug Medicare AllowedAmount |
2972.03 |
Total Drug Medicare PaymentAmount |
2813.77 |
Total Drug Medicare Standardized Payment Amount |
2813.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
9803 |
Number Of Medicare Beneficiaries With Medical Services |
990 |
Total Medical Submitted Charge Amount |
1027883.2 |
Total Medical Medicare Allowed Amount |
377667.64 |
Total Medical Medicare Payment Amount |
267931.56 |
Total Medical Medicare Standardized Payment Amount |
281001.33 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
204 |
Number Of Beneficiaries Age 65 to 74 |
345 |
Number Of Beneficiaries Age 75 to 84 |
281 |
Number Of Beneficiaries Age Greater 84 |
160 |
Number Of Female Beneficiaries |
599 |
Number Of Male Beneficiaries |
391 |
Number Of Non Hispanic White Beneficiaries |
655 |
Number Of Black or African American Beneficiaries |
199 |
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
48 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
581 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
409 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0739 |