National Provider Identifier [NPI]: |
1053541821 |
Last Name Of The Provider |
CLAVER |
First Name Of The Provider |
HAROLD |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 WESLEY CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOORE |
Zip Code Of The Provider |
731607557 |
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 |
27 |
Number Of Services |
1001 |
Number Of Medicare Beneficiaries |
815 |
Total Submitted Charge Amount |
373615 |
Total Medicare Allowed Amount |
123229.99 |
Total Medicare Payment Amount |
88118.48 |
Total Medicare Standardized Payment Amount |
92072.68 |
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 |
27 |
Number Of Medical Services |
1001 |
Number Of Medicare Beneficiaries With Medical Services |
815 |
Total Medical Submitted Charge Amount |
373615 |
Total Medical Medicare Allowed Amount |
123229.99 |
Total Medical Medicare Payment Amount |
88118.48 |
Total Medical Medicare Standardized Payment Amount |
92072.68 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
301 |
Number Of Beneficiaries Age 65 to 74 |
233 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
493 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
660 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
78 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
459 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
356 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6239 |