National Provider Identifier [NPI]: |
1508101783 |
Last Name Of The Provider |
DODSON |
First Name Of The Provider |
LINDSEY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4401 S WESTERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731093413 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
247 |
Number Of Medicare Beneficiaries |
86 |
Total Submitted Charge Amount |
40447 |
Total Medicare Allowed Amount |
20480.84 |
Total Medicare Payment Amount |
15875.55 |
Total Medicare Standardized Payment Amount |
16771.74 |
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 |
16 |
Number Of Medical Services |
247 |
Number Of Medicare Beneficiaries With Medical Services |
86 |
Total Medical Submitted Charge Amount |
40447 |
Total Medical Medicare Allowed Amount |
20480.84 |
Total Medical Medicare Payment Amount |
15875.55 |
Total Medical Medicare Standardized Payment Amount |
16771.74 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
62 |
Number Of Black or African American Beneficiaries |
|
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
1.6349 |