National Provider Identifier [NPI]: |
1255321063 |
Last Name Of The Provider |
DUNHAM |
First Name Of The Provider |
RORY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3110 SW 89TH ST |
Street Address 2 Of The Provider |
SUITE 200C |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
73159 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
107 |
Number Of Services |
2291 |
Number Of Medicare Beneficiaries |
295 |
Total Submitted Charge Amount |
476520.2 |
Total Medicare Allowed Amount |
162785.63 |
Total Medicare Payment Amount |
123148.18 |
Total Medicare Standardized Payment Amount |
132717.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1286 |
Number Of Medicare Beneficiaries With Drug Services |
77 |
Total Drug Submitted ChargeAmount |
36666 |
Total Drug Medicare AllowedAmount |
16497.31 |
Total Drug Medicare PaymentAmount |
12924.64 |
Total Drug Medicare Standardized Payment Amount |
12924.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
101 |
Number Of Medical Services |
1005 |
Number Of Medicare Beneficiaries With Medical Services |
295 |
Total Medical Submitted Charge Amount |
439854.2 |
Total Medical Medicare Allowed Amount |
146288.32 |
Total Medical Medicare Payment Amount |
110223.54 |
Total Medical Medicare Standardized Payment Amount |
119793.24 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
249 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1392 |