National Provider Identifier [NPI]: |
1538105291 |
Last Name Of The Provider |
ROYTMAN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4200 W MEMORIAL RD |
Street Address 2 Of The Provider |
# 406 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731209350 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
5929 |
Number Of Medicare Beneficiaries |
807 |
Total Submitted Charge Amount |
444163 |
Total Medicare Allowed Amount |
218120.22 |
Total Medicare Payment Amount |
159686.87 |
Total Medicare Standardized Payment Amount |
175667 |
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 |
35 |
Number Of Medical Services |
5929 |
Number Of Medicare Beneficiaries With Medical Services |
807 |
Total Medical Submitted Charge Amount |
444163 |
Total Medical Medicare Allowed Amount |
218120.22 |
Total Medical Medicare Payment Amount |
159686.87 |
Total Medical Medicare Standardized Payment Amount |
175667 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
315 |
Number Of Beneficiaries Age 75 to 84 |
329 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
308 |
Number Of Male Beneficiaries |
499 |
Number Of Non Hispanic White Beneficiaries |
782 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
796 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0574 |