National Provider Identifier [NPI]: |
1194721365 |
Last Name Of The Provider |
FOSTER |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3130 SW 89TH ST |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731597900 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
471 |
Number Of Medicare Beneficiaries |
82 |
Total Submitted Charge Amount |
46144 |
Total Medicare Allowed Amount |
22294.94 |
Total Medicare Payment Amount |
14837.51 |
Total Medicare Standardized Payment Amount |
16768.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
198 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1224 |
Total Drug Medicare AllowedAmount |
1130.04 |
Total Drug Medicare PaymentAmount |
758.76 |
Total Drug Medicare Standardized Payment Amount |
758.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
273 |
Number Of Medicare Beneficiaries With Medical Services |
82 |
Total Medical Submitted Charge Amount |
44920 |
Total Medical Medicare Allowed Amount |
21164.9 |
Total Medical Medicare Payment Amount |
14078.75 |
Total Medical Medicare Standardized Payment Amount |
16009.57 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
49 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0476 |