National Provider Identifier [NPI]: |
1588609630 |
Last Name Of The Provider |
BOKE |
First Name Of The Provider |
BRANDON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1003 WOODLAND DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPEARFISH |
Zip Code Of The Provider |
577839578 |
State Code Of The Provider |
SD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
793 |
Number Of Medicare Beneficiaries |
587 |
Total Submitted Charge Amount |
479337 |
Total Medicare Allowed Amount |
88129.56 |
Total Medicare Payment Amount |
67540.05 |
Total Medicare Standardized Payment Amount |
70414.63 |
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 |
35 |
Number Of Medical Services |
793 |
Number Of Medicare Beneficiaries With Medical Services |
587 |
Total Medical Submitted Charge Amount |
479337 |
Total Medical Medicare Allowed Amount |
88129.56 |
Total Medical Medicare Payment Amount |
67540.05 |
Total Medical Medicare Standardized Payment Amount |
70414.63 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
348 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
429 |
Number Of Black or African American Beneficiaries |
113 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
23 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
373 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
214 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9627 |