National Provider Identifier [NPI]: |
1902877749 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
SHERRI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
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 |
36 |
Number Of Services |
686 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
86968 |
Total Medicare Allowed Amount |
45353.52 |
Total Medicare Payment Amount |
29580.35 |
Total Medicare Standardized Payment Amount |
32861.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
127 |
Number Of Medicare Beneficiaries With Drug Services |
64 |
Total Drug Submitted ChargeAmount |
1638 |
Total Drug Medicare AllowedAmount |
959.82 |
Total Drug Medicare PaymentAmount |
891.12 |
Total Drug Medicare Standardized Payment Amount |
891.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
559 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
85330 |
Total Medical Medicare Allowed Amount |
44393.7 |
Total Medical Medicare Payment Amount |
28689.23 |
Total Medical Medicare Standardized Payment Amount |
31969.91 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
182 |
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 |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.938 |