National Provider Identifier [NPI]: |
1932142866 |
Last Name Of The Provider |
CHAINAKUL |
First Name Of The Provider |
WEERA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1809 E 13TH ST |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741044419 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
1313 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
427634 |
Total Medicare Allowed Amount |
146585.17 |
Total Medicare Payment Amount |
113102.8 |
Total Medicare Standardized Payment Amount |
116791.43 |
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 |
100 |
Number Of Medical Services |
1313 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
427634 |
Total Medical Medicare Allowed Amount |
146585.17 |
Total Medical Medicare Payment Amount |
113102.8 |
Total Medical Medicare Standardized Payment Amount |
116791.43 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
95 |
Number Of Non Hispanic White Beneficiaries |
122 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
33 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0003 |