National Provider Identifier [NPI]: |
1568406767 |
Last Name Of The Provider |
GOLIGHTLY |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3401 W GORE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAWTON |
Zip Code Of The Provider |
735056332 |
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 |
37 |
Number Of Services |
1537 |
Number Of Medicare Beneficiaries |
851 |
Total Submitted Charge Amount |
867981 |
Total Medicare Allowed Amount |
142998.34 |
Total Medicare Payment Amount |
109592.77 |
Total Medicare Standardized Payment Amount |
114339.92 |
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 |
37 |
Number Of Medical Services |
1537 |
Number Of Medicare Beneficiaries With Medical Services |
851 |
Total Medical Submitted Charge Amount |
867981 |
Total Medical Medicare Allowed Amount |
142998.34 |
Total Medical Medicare Payment Amount |
109592.77 |
Total Medical Medicare Standardized Payment Amount |
114339.92 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
313 |
Number Of Beneficiaries Age 65 to 74 |
235 |
Number Of Beneficiaries Age 75 to 84 |
191 |
Number Of Beneficiaries Age Greater 84 |
112 |
Number Of Female Beneficiaries |
537 |
Number Of Male Beneficiaries |
314 |
Number Of Non Hispanic White Beneficiaries |
602 |
Number Of Black or African American Beneficiaries |
89 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
76 |
Number Of American Indian Alaska Native Beneficiaries |
60 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
418 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
433 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8676 |