National Provider Identifier [NPI]: |
1720039100 |
Last Name Of The Provider |
HOOVER |
First Name Of The Provider |
GEOFFREY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
122 N BRYANT AVE |
Street Address 2 Of The Provider |
SUITE 1B |
City Of The Provider |
EDMOND |
Zip Code Of The Provider |
730346303 |
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 |
74 |
Number Of Services |
1772 |
Number Of Medicare Beneficiaries |
371 |
Total Submitted Charge Amount |
164093 |
Total Medicare Allowed Amount |
98914.05 |
Total Medicare Payment Amount |
69059.55 |
Total Medicare Standardized Payment Amount |
75758.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
142 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
3382 |
Total Drug Medicare AllowedAmount |
1637.52 |
Total Drug Medicare PaymentAmount |
1548.19 |
Total Drug Medicare Standardized Payment Amount |
1548.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
1630 |
Number Of Medicare Beneficiaries With Medical Services |
371 |
Total Medical Submitted Charge Amount |
160711 |
Total Medical Medicare Allowed Amount |
97276.53 |
Total Medical Medicare Payment Amount |
67511.36 |
Total Medical Medicare Standardized Payment Amount |
74210.24 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
333 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9649 |