National Provider Identifier [NPI]: |
1710914718 |
Last Name Of The Provider |
ESPARZA |
First Name Of The Provider |
NATALIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11000 HEFNER POINTE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731205039 |
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 |
99 |
Number Of Services |
5047 |
Number Of Medicare Beneficiaries |
495 |
Total Submitted Charge Amount |
239045.23 |
Total Medicare Allowed Amount |
227495.03 |
Total Medicare Payment Amount |
170025.38 |
Total Medicare Standardized Payment Amount |
186313.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
133 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
17625.29 |
Total Drug Medicare AllowedAmount |
17565.39 |
Total Drug Medicare PaymentAmount |
13771.36 |
Total Drug Medicare Standardized Payment Amount |
13771.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
4914 |
Number Of Medicare Beneficiaries With Medical Services |
495 |
Total Medical Submitted Charge Amount |
221419.94 |
Total Medical Medicare Allowed Amount |
209929.64 |
Total Medical Medicare Payment Amount |
156254.02 |
Total Medical Medicare Standardized Payment Amount |
172542.49 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
214 |
Number Of Beneficiaries Age 75 to 84 |
176 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
353 |
Number Of Male Beneficiaries |
142 |
Number Of Non Hispanic White Beneficiaries |
441 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
28 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
421 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1596 |