National Provider Identifier [NPI]: |
1427089432 |
Last Name Of The Provider |
GONZALEZ |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6201 N SANTA FE AVE |
Street Address 2 Of The Provider |
SUITE 2010 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731187538 |
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 |
32 |
Number Of Services |
909 |
Number Of Medicare Beneficiaries |
391 |
Total Submitted Charge Amount |
122193.23 |
Total Medicare Allowed Amount |
66747.61 |
Total Medicare Payment Amount |
48963.6 |
Total Medicare Standardized Payment Amount |
52081.3 |
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 |
32 |
Number Of Medical Services |
909 |
Number Of Medicare Beneficiaries With Medical Services |
391 |
Total Medical Submitted Charge Amount |
122193.23 |
Total Medical Medicare Allowed Amount |
66747.61 |
Total Medical Medicare Payment Amount |
48963.6 |
Total Medical Medicare Standardized Payment Amount |
52081.3 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
246 |
Number Of Black or African American Beneficiaries |
107 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
181 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.713 |