National Provider Identifier [NPI]: |
1366411282 |
Last Name Of The Provider |
MCCLINTOCK |
First Name Of The Provider |
LYNN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1705 E 19TH ST |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741045405 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
781 |
Number Of Medicare Beneficiaries |
736 |
Total Submitted Charge Amount |
295105 |
Total Medicare Allowed Amount |
139121.42 |
Total Medicare Payment Amount |
105064.64 |
Total Medicare Standardized Payment Amount |
112942.3 |
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 |
10 |
Number Of Medical Services |
781 |
Number Of Medicare Beneficiaries With Medical Services |
736 |
Total Medical Submitted Charge Amount |
295105 |
Total Medical Medicare Allowed Amount |
139121.42 |
Total Medical Medicare Payment Amount |
105064.64 |
Total Medical Medicare Standardized Payment Amount |
112942.3 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
163 |
Number Of Beneficiaries Age 65 to 74 |
197 |
Number Of Beneficiaries Age 75 to 84 |
219 |
Number Of Beneficiaries Age Greater 84 |
157 |
Number Of Female Beneficiaries |
411 |
Number Of Male Beneficiaries |
325 |
Number Of Non Hispanic White Beneficiaries |
568 |
Number Of Black or African American Beneficiaries |
91 |
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 |
492 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
244 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.0107 |