National Provider Identifier [NPI]: |
1528018942 |
Last Name Of The Provider |
STEPHENS |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4334 NW EXPRESSWAY |
Street Address 2 Of The Provider |
SUITE 175 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731161578 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
2339 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
224618.23 |
Total Medicare Allowed Amount |
224545.24 |
Total Medicare Payment Amount |
168787.7 |
Total Medicare Standardized Payment Amount |
178872.53 |
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 |
11 |
Number Of Medical Services |
2339 |
Number Of Medicare Beneficiaries With Medical Services |
527 |
Total Medical Submitted Charge Amount |
224618.23 |
Total Medical Medicare Allowed Amount |
224545.24 |
Total Medical Medicare Payment Amount |
168787.7 |
Total Medical Medicare Standardized Payment Amount |
178872.53 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
175 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
425 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
18 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
226 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.406 |