National Provider Identifier [NPI]: |
1669478244 |
Last Name Of The Provider |
WORRELL |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3201 N VAN BUREN ST |
Street Address 2 Of The Provider |
STE 600 |
City Of The Provider |
ENID |
Zip Code Of The Provider |
737031815 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
109 |
Number Of Services |
2243 |
Number Of Medicare Beneficiaries |
754 |
Total Submitted Charge Amount |
386933.5 |
Total Medicare Allowed Amount |
310224.34 |
Total Medicare Payment Amount |
235635.82 |
Total Medicare Standardized Payment Amount |
265474.11 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
251 |
Number Of Beneficiaries Age 75 to 84 |
322 |
Number Of Beneficiaries Age Greater 84 |
160 |
Number Of Female Beneficiaries |
341 |
Number Of Male Beneficiaries |
413 |
Number Of Non Hispanic White Beneficiaries |
735 |
Number Of Black or African American Beneficiaries |
|
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 |
720 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.04 |