National Provider Identifier [NPI]: |
1083619902 |
Last Name Of The Provider |
MCKEOWN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6839 S CANTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741363402 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
219 |
Number Of Medicare Beneficiaries |
145 |
Total Submitted Charge Amount |
318220.3 |
Total Medicare Allowed Amount |
68253.59 |
Total Medicare Payment Amount |
53127.12 |
Total Medicare Standardized Payment Amount |
55252.41 |
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 |
57 |
Number Of Medical Services |
219 |
Number Of Medicare Beneficiaries With Medical Services |
145 |
Total Medical Submitted Charge Amount |
318220.3 |
Total Medical Medicare Allowed Amount |
68253.59 |
Total Medical Medicare Payment Amount |
53127.12 |
Total Medical Medicare Standardized Payment Amount |
55252.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
122 |
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 |
107 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.632 |