National Provider Identifier [NPI]: |
1912998857 |
Last Name Of The Provider |
BRYANT |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
P A C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
603 NE 2ND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANTLERS |
Zip Code Of The Provider |
745232636 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
3805 |
Number Of Medicare Beneficiaries |
375 |
Total Submitted Charge Amount |
219731.91 |
Total Medicare Allowed Amount |
96390.34 |
Total Medicare Payment Amount |
70512.96 |
Total Medicare Standardized Payment Amount |
86816.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
69 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
956.45 |
Total Drug Medicare AllowedAmount |
390.23 |
Total Drug Medicare PaymentAmount |
368.25 |
Total Drug Medicare Standardized Payment Amount |
368.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
100 |
Number Of Medical Services |
3736 |
Number Of Medicare Beneficiaries With Medical Services |
375 |
Total Medical Submitted Charge Amount |
218775.46 |
Total Medical Medicare Allowed Amount |
96000.11 |
Total Medical Medicare Payment Amount |
70144.71 |
Total Medical Medicare Standardized Payment Amount |
86448.18 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
332 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
29 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
229 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0538 |