National Provider Identifier [NPI]: |
1316142359 |
Last Name Of The Provider |
COBB |
First Name Of The Provider |
ESTER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 N BRYANT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EDMOND |
Zip Code Of The Provider |
730346273 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
10633 |
Number Of Medicare Beneficiaries |
363 |
Total Submitted Charge Amount |
406066.68 |
Total Medicare Allowed Amount |
215920.3 |
Total Medicare Payment Amount |
164971.05 |
Total Medicare Standardized Payment Amount |
174053.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
469 |
Number Of Medicare Beneficiaries With Drug Services |
164 |
Total Drug Submitted ChargeAmount |
13136.68 |
Total Drug Medicare AllowedAmount |
4303.66 |
Total Drug Medicare PaymentAmount |
4033.82 |
Total Drug Medicare Standardized Payment Amount |
4033.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
10164 |
Number Of Medicare Beneficiaries With Medical Services |
363 |
Total Medical Submitted Charge Amount |
392930 |
Total Medical Medicare Allowed Amount |
211616.64 |
Total Medical Medicare Payment Amount |
160937.23 |
Total Medical Medicare Standardized Payment Amount |
170019.88 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
323 |
Number Of Black or African American Beneficiaries |
21 |
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 |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1279 |