National Provider Identifier [NPI]: |
1962438739 |
Last Name Of The Provider |
BRADFORD |
First Name Of The Provider |
ALVIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 S TELEPHONE RD STE 250 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOORE |
Zip Code Of The Provider |
731602969 |
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 |
22 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
515 |
Total Submitted Charge Amount |
532290 |
Total Medicare Allowed Amount |
84416.95 |
Total Medicare Payment Amount |
64737.14 |
Total Medicare Standardized Payment Amount |
67699.74 |
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 |
22 |
Number Of Medical Services |
586 |
Number Of Medicare Beneficiaries With Medical Services |
515 |
Total Medical Submitted Charge Amount |
532290 |
Total Medical Medicare Allowed Amount |
84416.95 |
Total Medical Medicare Payment Amount |
64737.14 |
Total Medical Medicare Standardized Payment Amount |
67699.74 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
206 |
Number Of Non Hispanic White Beneficiaries |
465 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
31 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
338 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
177 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7845 |