National Provider Identifier [NPI]: |
1477540839 |
Last Name Of The Provider |
JENNINGS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4111 S DARLINGTON AVE |
Street Address 2 Of The Provider |
STE 700 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741356348 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
170 |
Number Of Services |
4988 |
Number Of Medicare Beneficiaries |
3268 |
Total Submitted Charge Amount |
459464.5 |
Total Medicare Allowed Amount |
149593.27 |
Total Medicare Payment Amount |
109385.12 |
Total Medicare Standardized Payment Amount |
116877.34 |
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 |
170 |
Number Of Medical Services |
4988 |
Number Of Medicare Beneficiaries With Medical Services |
3268 |
Total Medical Submitted Charge Amount |
459464.5 |
Total Medical Medicare Allowed Amount |
149593.27 |
Total Medical Medicare Payment Amount |
109385.12 |
Total Medical Medicare Standardized Payment Amount |
116877.34 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
585 |
Number Of Beneficiaries Age 65 to 74 |
1266 |
Number Of Beneficiaries Age 75 to 84 |
918 |
Number Of Beneficiaries Age Greater 84 |
499 |
Number Of Female Beneficiaries |
2017 |
Number Of Male Beneficiaries |
1251 |
Number Of Non Hispanic White Beneficiaries |
2797 |
Number Of Black or African American Beneficiaries |
153 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
234 |
Number Of Beneficiaries With Race Not Else where Classified |
25 |
Number Of Beneficiaries With Medicare Only Entitlement |
2594 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
674 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5845 |