National Provider Identifier [NPI]: |
1962441865 |
Last Name Of The Provider |
SHAFFER |
First Name Of The Provider |
RODNEY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4111 S DARLINGTON AVE |
Street Address 2 Of The Provider |
SUITE 700 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741356348 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
163 |
Number Of Services |
6989 |
Number Of Medicare Beneficiaries |
4522 |
Total Submitted Charge Amount |
787203 |
Total Medicare Allowed Amount |
256300.22 |
Total Medicare Payment Amount |
194442.11 |
Total Medicare Standardized Payment Amount |
207658.99 |
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 |
163 |
Number Of Medical Services |
6989 |
Number Of Medicare Beneficiaries With Medical Services |
4522 |
Total Medical Submitted Charge Amount |
787203 |
Total Medical Medicare Allowed Amount |
256300.22 |
Total Medical Medicare Payment Amount |
194442.11 |
Total Medical Medicare Standardized Payment Amount |
207658.99 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
974 |
Number Of Beneficiaries Age 65 to 74 |
1561 |
Number Of Beneficiaries Age 75 to 84 |
1255 |
Number Of Beneficiaries Age Greater 84 |
732 |
Number Of Female Beneficiaries |
2673 |
Number Of Male Beneficiaries |
1849 |
Number Of Non Hispanic White Beneficiaries |
3667 |
Number Of Black or African American Beneficiaries |
375 |
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
361 |
Number Of Beneficiaries With Race Not Else where Classified |
35 |
Number Of Beneficiaries With Medicare Only Entitlement |
3278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1244 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.6009 |