National Provider Identifier [NPI]: |
1588644660 |
Last Name Of The Provider |
GRAY |
First Name Of The Provider |
GREG |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10501 E 91ST ST |
Street Address 2 Of The Provider |
EMERGENCY DEPT |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741335790 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
955 |
Number Of Medicare Beneficiaries |
687 |
Total Submitted Charge Amount |
514342.8 |
Total Medicare Allowed Amount |
108098.42 |
Total Medicare Payment Amount |
82187.79 |
Total Medicare Standardized Payment Amount |
86468.3 |
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 |
33 |
Number Of Medical Services |
955 |
Number Of Medicare Beneficiaries With Medical Services |
687 |
Total Medical Submitted Charge Amount |
514342.8 |
Total Medical Medicare Allowed Amount |
108098.42 |
Total Medical Medicare Payment Amount |
82187.79 |
Total Medical Medicare Standardized Payment Amount |
86468.3 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
401 |
Number Of Male Beneficiaries |
286 |
Number Of Non Hispanic White Beneficiaries |
587 |
Number Of Black or African American Beneficiaries |
42 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
35 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
546 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6888 |