National Provider Identifier [NPI]: |
1316940117 |
Last Name Of The Provider |
ALY |
First Name Of The Provider |
ALY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3366 NW EXPRESSWAY BLDG D |
Street Address 2 Of The Provider |
SUITE 730 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731124462 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
6452 |
Number Of Medicare Beneficiaries |
632 |
Total Submitted Charge Amount |
782432.5 |
Total Medicare Allowed Amount |
387708.37 |
Total Medicare Payment Amount |
296563.36 |
Total Medicare Standardized Payment Amount |
306843.35 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
199 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
305 |
Number Of Male Beneficiaries |
327 |
Number Of Non Hispanic White Beneficiaries |
459 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
60 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
464 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
3.7313 |