National Provider Identifier [NPI]: |
1689866576 |
Last Name Of The Provider |
PHELPS |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1008 NW 139TH STREET PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDMOND |
Zip Code Of The Provider |
730139791 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
10270 |
Number Of Medicare Beneficiaries |
998 |
Total Submitted Charge Amount |
2466775 |
Total Medicare Allowed Amount |
1448576.87 |
Total Medicare Payment Amount |
1120112.04 |
Total Medicare Standardized Payment Amount |
1171360.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
3477 |
Number Of Medicare Beneficiaries With Drug Services |
336 |
Total Drug Submitted ChargeAmount |
1107933 |
Total Drug Medicare AllowedAmount |
686662.65 |
Total Drug Medicare PaymentAmount |
537375.48 |
Total Drug Medicare Standardized Payment Amount |
537375.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
6793 |
Number Of Medicare Beneficiaries With Medical Services |
998 |
Total Medical Submitted Charge Amount |
1358842 |
Total Medical Medicare Allowed Amount |
761914.22 |
Total Medical Medicare Payment Amount |
582736.56 |
Total Medical Medicare Standardized Payment Amount |
633984.85 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
389 |
Number Of Beneficiaries Age 75 to 84 |
362 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
593 |
Number Of Male Beneficiaries |
405 |
Number Of Non Hispanic White Beneficiaries |
902 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
25 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
890 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1995 |