Medicare Facts for Doris J. Chediak, MSW


National Provider Identifier [NPI]: 1063515690
Last Name Of The Provider CHEDIAK
First Name Of The Provider DORIS
Middle Initial Of The Provider J
Credentials Of The Provider MSW
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 3037 NW 63RD STREET
Street Address 2 Of The Provider SUITE 100W
City Of The Provider OKLAHOMA CITY
Zip Code Of The Provider 731163608
State Code Of The Provider OK
Country Code Of The Provider US
Provider Type Of The Provider Licensed Clinical Social Worker
Medicare Participation Indicator Y
Number Of HCPCS 1
Number Of Services 190
Number Of Medicare Beneficiaries 13
Total Submitted Charge Amount 19000.06
Total Medicare Allowed Amount 17875.2
Total Medicare Payment Amount 13987.89
Total Medicare Standardized Payment Amount 14199.2
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 1
Number Of Medical Services 190
Number Of Medicare Beneficiaries With Medical Services 13
Total Medical Submitted Charge Amount 19000.06
Total Medical Medicare Allowed Amount 17875.2
Total Medical Medicare Payment Amount 13987.89
Total Medical Medicare Standardized Payment Amount 14199.2
Average Age Of Beneficiaries 71
Number Of Beneficiaries Age Less65 0
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries
Number Of Male Beneficiaries
Number Of Non Hispanic White Beneficiaries 13
Number Of Black or African American Beneficiaries 0
Number Of AsianPacific Islander Beneficiaries 0
Number Of Hispanic Beneficiaries 0
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified 0
Number Of Beneficiaries With Medicare Only Entitlement 13
Number Of Beneficiaries With Medicare Medicaid Entitlement 0
Percent Of With Atrial Fibrillation 0
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression
Percent Of With Diabetes
Percent Of With Hyperlipidemia
Percent Of With Hypertension
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders 0
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 0.7808

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