National Provider Identifier [NPI]: |
1265596969 |
Last Name Of The Provider |
AXTON |
First Name Of The Provider |
JON |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5300 N GRAND BLVD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731125647 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
6259 |
Number Of Medicare Beneficiaries |
597 |
Total Submitted Charge Amount |
784655.06 |
Total Medicare Allowed Amount |
237479.48 |
Total Medicare Payment Amount |
184641.64 |
Total Medicare Standardized Payment Amount |
195034.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
722 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
177176 |
Total Drug Medicare AllowedAmount |
51184.96 |
Total Drug Medicare PaymentAmount |
38584.18 |
Total Drug Medicare Standardized Payment Amount |
38584.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
104 |
Number Of Medical Services |
5537 |
Number Of Medicare Beneficiaries With Medical Services |
597 |
Total Medical Submitted Charge Amount |
607479.06 |
Total Medical Medicare Allowed Amount |
186294.52 |
Total Medical Medicare Payment Amount |
146057.46 |
Total Medical Medicare Standardized Payment Amount |
156450.51 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
224 |
Number Of Beneficiaries Age 75 to 84 |
249 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
135 |
Number Of Male Beneficiaries |
462 |
Number Of Non Hispanic White Beneficiaries |
556 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
581 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0056 |