National Provider Identifier [NPI]: |
1891786000 |
Last Name Of The Provider |
GRAY |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1120 S UTICA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741044012 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1519 |
Number Of Medicare Beneficiaries |
946 |
Total Submitted Charge Amount |
804881 |
Total Medicare Allowed Amount |
150910.28 |
Total Medicare Payment Amount |
116091.04 |
Total Medicare Standardized Payment Amount |
121065.92 |
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 |
35 |
Number Of Medical Services |
1519 |
Number Of Medicare Beneficiaries With Medical Services |
946 |
Total Medical Submitted Charge Amount |
804881 |
Total Medical Medicare Allowed Amount |
150910.28 |
Total Medical Medicare Payment Amount |
116091.04 |
Total Medical Medicare Standardized Payment Amount |
121065.92 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
396 |
Number Of Beneficiaries Age 65 to 74 |
247 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
556 |
Number Of Male Beneficiaries |
390 |
Number Of Non Hispanic White Beneficiaries |
621 |
Number Of Black or African American Beneficiaries |
190 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
107 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
443 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
503 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9363 |