National Provider Identifier [NPI]: |
1770549057 |
Last Name Of The Provider |
OAKMAN |
First Name Of The Provider |
JERRY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12850 JONES ROAD |
Street Address 2 Of The Provider |
STE 102 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
77070 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
248 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
44142 |
Total Medicare Allowed Amount |
19434.16 |
Total Medicare Payment Amount |
12391.07 |
Total Medicare Standardized Payment Amount |
12458.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
727 |
Total Drug Medicare AllowedAmount |
302.28 |
Total Drug Medicare PaymentAmount |
289.31 |
Total Drug Medicare Standardized Payment Amount |
289.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
235 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
43415 |
Total Medical Medicare Allowed Amount |
19131.88 |
Total Medical Medicare Payment Amount |
12101.76 |
Total Medical Medicare Standardized Payment Amount |
12168.82 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
12 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6405 |