National Provider Identifier [NPI]: |
1558679035 |
Last Name Of The Provider |
WHITE |
First Name Of The Provider |
BROOKE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 S GARNETT RD STE 300 |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741465238 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
1152 |
Number Of Medicare Beneficiaries |
578 |
Total Submitted Charge Amount |
257934.15 |
Total Medicare Allowed Amount |
87086.12 |
Total Medicare Payment Amount |
73388.78 |
Total Medicare Standardized Payment Amount |
82781.47 |
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 |
58 |
Number Of Medical Services |
1152 |
Number Of Medicare Beneficiaries With Medical Services |
578 |
Total Medical Submitted Charge Amount |
257934.15 |
Total Medical Medicare Allowed Amount |
87086.12 |
Total Medical Medicare Payment Amount |
73388.78 |
Total Medical Medicare Standardized Payment Amount |
82781.47 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
185 |
Number Of Beneficiaries Age 65 to 74 |
245 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
506 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
394 |
Number Of Black or African American Beneficiaries |
127 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
40 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
228 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3769 |