National Provider Identifier [NPI]: |
1639153554 |
Last Name Of The Provider |
KEENER |
First Name Of The Provider |
ROSS |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 S WESTERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731093410 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
1209 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
546302.94 |
Total Medicare Allowed Amount |
152813.33 |
Total Medicare Payment Amount |
118765.71 |
Total Medicare Standardized Payment Amount |
128880.33 |
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 |
46 |
Number Of Medical Services |
1209 |
Number Of Medicare Beneficiaries With Medical Services |
506 |
Total Medical Submitted Charge Amount |
546302.94 |
Total Medical Medicare Allowed Amount |
152813.33 |
Total Medical Medicare Payment Amount |
118765.71 |
Total Medical Medicare Standardized Payment Amount |
128880.33 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
450 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
24 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
457 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3631 |