National Provider Identifier [NPI]: |
1134196207 |
Last Name Of The Provider |
REILLY |
First Name Of The Provider |
KATHRYN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 NE 10TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731045420 |
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 |
84 |
Number Of Services |
2679 |
Number Of Medicare Beneficiaries |
531 |
Total Submitted Charge Amount |
200658.5 |
Total Medicare Allowed Amount |
83104.19 |
Total Medicare Payment Amount |
61239.17 |
Total Medicare Standardized Payment Amount |
62893.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
21 |
Number Of Drug Services |
1098 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
12579.5 |
Total Drug Medicare AllowedAmount |
7582.45 |
Total Drug Medicare PaymentAmount |
6138.83 |
Total Drug Medicare Standardized Payment Amount |
6138.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
1581 |
Number Of Medicare Beneficiaries With Medical Services |
531 |
Total Medical Submitted Charge Amount |
188079 |
Total Medical Medicare Allowed Amount |
75521.74 |
Total Medical Medicare Payment Amount |
55100.34 |
Total Medical Medicare Standardized Payment Amount |
56754.6 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
288 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
256 |
Number Of Black or African American Beneficiaries |
237 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
319 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5141 |