National Provider Identifier [NPI]: |
1871607903 |
Last Name Of The Provider |
CARNAHAN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1104 WALNUT DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARDMORE |
Zip Code Of The Provider |
734012353 |
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 |
125 |
Number Of Services |
13787 |
Number Of Medicare Beneficiaries |
1259 |
Total Submitted Charge Amount |
420394.25 |
Total Medicare Allowed Amount |
396143.23 |
Total Medicare Payment Amount |
303277.63 |
Total Medicare Standardized Payment Amount |
335058.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
5460 |
Number Of Medicare Beneficiaries With Drug Services |
484 |
Total Drug Submitted ChargeAmount |
29764.14 |
Total Drug Medicare AllowedAmount |
18538.72 |
Total Drug Medicare PaymentAmount |
14737.71 |
Total Drug Medicare Standardized Payment Amount |
14737.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
108 |
Number Of Medical Services |
8327 |
Number Of Medicare Beneficiaries With Medical Services |
1259 |
Total Medical Submitted Charge Amount |
390630.11 |
Total Medical Medicare Allowed Amount |
377604.51 |
Total Medical Medicare Payment Amount |
288539.92 |
Total Medical Medicare Standardized Payment Amount |
320320.87 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
171 |
Number Of Beneficiaries Age 65 to 74 |
473 |
Number Of Beneficiaries Age 75 to 84 |
416 |
Number Of Beneficiaries Age Greater 84 |
199 |
Number Of Female Beneficiaries |
779 |
Number Of Male Beneficiaries |
480 |
Number Of Non Hispanic White Beneficiaries |
1088 |
Number Of Black or African American Beneficiaries |
73 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
76 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1003 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
256 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3443 |