National Provider Identifier [NPI]: |
1942531819 |
Last Name Of The Provider |
HENDLEY |
First Name Of The Provider |
HALSTON |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2825 PARKLAWN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDWEST CITY |
Zip Code Of The Provider |
731104201 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
378 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
250868 |
Total Medicare Allowed Amount |
31663.31 |
Total Medicare Payment Amount |
23884.13 |
Total Medicare Standardized Payment Amount |
29666.86 |
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 |
20 |
Number Of Medical Services |
378 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
250868 |
Total Medical Medicare Allowed Amount |
31663.31 |
Total Medical Medicare Payment Amount |
23884.13 |
Total Medical Medicare Standardized Payment Amount |
29666.86 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
140 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
184 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6176 |