National Provider Identifier [NPI]: |
1942280987 |
Last Name Of The Provider |
FEY |
First Name Of The Provider |
VICTOR |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
90 N 30TH ST |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
CLINTON |
Zip Code Of The Provider |
736013100 |
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 |
66 |
Number Of Services |
2194 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
380043.6 |
Total Medicare Allowed Amount |
128435.66 |
Total Medicare Payment Amount |
91773.67 |
Total Medicare Standardized Payment Amount |
99462.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
217 |
Number Of Medicare Beneficiaries With Drug Services |
90 |
Total Drug Submitted ChargeAmount |
6894 |
Total Drug Medicare AllowedAmount |
1553.79 |
Total Drug Medicare PaymentAmount |
1481.06 |
Total Drug Medicare Standardized Payment Amount |
1481.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
1977 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
373149.6 |
Total Medical Medicare Allowed Amount |
126881.87 |
Total Medical Medicare Payment Amount |
90292.61 |
Total Medical Medicare Standardized Payment Amount |
97981.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
329 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
17 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
289 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.4486 |