National Provider Identifier [NPI]: |
1497803209 |
Last Name Of The Provider |
OKWUASABA |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8803 S 101ST EAST AVE |
Street Address 2 Of The Provider |
SUITE 350 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741335726 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
35081 |
Number Of Medicare Beneficiaries |
703 |
Total Submitted Charge Amount |
936434.23 |
Total Medicare Allowed Amount |
416214.89 |
Total Medicare Payment Amount |
317910.6 |
Total Medicare Standardized Payment Amount |
342240.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
30802 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
227231.4 |
Total Drug Medicare AllowedAmount |
29158.22 |
Total Drug Medicare PaymentAmount |
20107.44 |
Total Drug Medicare Standardized Payment Amount |
20107.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
4279 |
Number Of Medicare Beneficiaries With Medical Services |
703 |
Total Medical Submitted Charge Amount |
709202.83 |
Total Medical Medicare Allowed Amount |
387056.67 |
Total Medical Medicare Payment Amount |
297803.16 |
Total Medical Medicare Standardized Payment Amount |
322133.27 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
265 |
Number Of Beneficiaries Age 65 to 74 |
236 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
338 |
Number Of Male Beneficiaries |
365 |
Number Of Non Hispanic White Beneficiaries |
492 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
132 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
307 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
3.1285 |