National Provider Identifier [NPI]: |
1558331959 |
Last Name Of The Provider |
BOLDING |
First Name Of The Provider |
PAT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6600 S YALE AVE |
Street Address 2 Of The Provider |
STE 700 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741363310 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1609 |
Number Of Medicare Beneficiaries |
357 |
Total Submitted Charge Amount |
168188 |
Total Medicare Allowed Amount |
87290.72 |
Total Medicare Payment Amount |
55862.29 |
Total Medicare Standardized Payment Amount |
63022.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
321 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
3255 |
Total Drug Medicare AllowedAmount |
2059.53 |
Total Drug Medicare PaymentAmount |
1889.28 |
Total Drug Medicare Standardized Payment Amount |
1889.28 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
1288 |
Number Of Medicare Beneficiaries With Medical Services |
357 |
Total Medical Submitted Charge Amount |
164933 |
Total Medical Medicare Allowed Amount |
85231.19 |
Total Medical Medicare Payment Amount |
53973.01 |
Total Medical Medicare Standardized Payment Amount |
61133.6 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
304 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
25 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
303 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1169 |