National Provider Identifier [NPI]: |
1669463865 |
Last Name Of The Provider |
DIXON |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 S UTICA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741044012 |
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 |
17 |
Number Of Services |
645 |
Number Of Medicare Beneficiaries |
433 |
Total Submitted Charge Amount |
368815 |
Total Medicare Allowed Amount |
69446.1 |
Total Medicare Payment Amount |
52148.39 |
Total Medicare Standardized Payment Amount |
54449.08 |
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 |
17 |
Number Of Medical Services |
645 |
Number Of Medicare Beneficiaries With Medical Services |
433 |
Total Medical Submitted Charge Amount |
368815 |
Total Medical Medicare Allowed Amount |
69446.1 |
Total Medical Medicare Payment Amount |
52148.39 |
Total Medical Medicare Standardized Payment Amount |
54449.08 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
179 |
Number Of Non Hispanic White Beneficiaries |
285 |
Number Of Black or African American Beneficiaries |
96 |
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 |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
228 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7784 |