National Provider Identifier [NPI]: |
1255342416 |
Last Name Of The Provider |
AHN |
First Name Of The Provider |
DUKHEH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
94 N 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLINTON |
Zip Code Of The Provider |
736019116 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
917 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
81005 |
Total Medicare Allowed Amount |
73491.87 |
Total Medicare Payment Amount |
53196.05 |
Total Medicare Standardized Payment Amount |
57337.41 |
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 |
5 |
Number Of Medical Services |
917 |
Number Of Medicare Beneficiaries With Medical Services |
152 |
Total Medical Submitted Charge Amount |
81005 |
Total Medical Medicare Allowed Amount |
73491.87 |
Total Medical Medicare Payment Amount |
53196.05 |
Total Medical Medicare Standardized Payment Amount |
57337.41 |
Average Age Of Beneficiaries |
50 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
72 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
41 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
35 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0768 |