National Provider Identifier [NPI]: |
1356300800 |
Last Name Of The Provider |
LODES |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M. D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1919 S WHEELING AVE |
Street Address 2 Of The Provider |
300 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741045638 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
48703.5 |
Total Medicare Allowed Amount |
29449.75 |
Total Medicare Payment Amount |
20036.31 |
Total Medicare Standardized Payment Amount |
21939.25 |
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 |
18 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
228 |
Total Medical Submitted Charge Amount |
48703.5 |
Total Medical Medicare Allowed Amount |
29449.75 |
Total Medical Medicare Payment Amount |
20036.31 |
Total Medical Medicare Standardized Payment Amount |
21939.25 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
208 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
11 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7584 |