National Provider Identifier [NPI]: |
1053567784 |
Last Name Of The Provider |
VASSILIOU |
First Name Of The Provider |
CHRISTOS |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 S GARNETT RD |
Street Address 2 Of The Provider |
STE 919 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741465229 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
220 |
Number Of Services |
6833 |
Number Of Medicare Beneficiaries |
3943 |
Total Submitted Charge Amount |
891022.66 |
Total Medicare Allowed Amount |
182329.02 |
Total Medicare Payment Amount |
142194.17 |
Total Medicare Standardized Payment Amount |
150971.9 |
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 |
69 |
Number Of Beneficiaries Age Less65 |
1019 |
Number Of Beneficiaries Age 65 to 74 |
1652 |
Number Of Beneficiaries Age 75 to 84 |
965 |
Number Of Beneficiaries Age Greater 84 |
307 |
Number Of Female Beneficiaries |
2868 |
Number Of Male Beneficiaries |
1075 |
Number Of Non Hispanic White Beneficiaries |
2383 |
Number Of Black or African American Beneficiaries |
228 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
1262 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2589 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1354 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5682 |