National Provider Identifier [NPI]: |
1265537757 |
Last Name Of The Provider |
GARTZKE |
First Name Of The Provider |
ALFRED |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9716 RIVERSIDE PKWY |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
74137 |
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 |
77 |
Number Of Services |
1006 |
Number Of Medicare Beneficiaries |
470 |
Total Submitted Charge Amount |
255991 |
Total Medicare Allowed Amount |
46590.36 |
Total Medicare Payment Amount |
34315.11 |
Total Medicare Standardized Payment Amount |
43458.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
257 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
996 |
Total Drug Medicare AllowedAmount |
155.48 |
Total Drug Medicare PaymentAmount |
109.48 |
Total Drug Medicare Standardized Payment Amount |
109.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
749 |
Number Of Medicare Beneficiaries With Medical Services |
470 |
Total Medical Submitted Charge Amount |
254995 |
Total Medical Medicare Allowed Amount |
46434.88 |
Total Medical Medicare Payment Amount |
34205.63 |
Total Medical Medicare Standardized Payment Amount |
43349.22 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
289 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
401 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
36 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
343 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.244 |