National Provider Identifier [NPI]: |
1013963115 |
Last Name Of The Provider |
OWENS |
First Name Of The Provider |
TOMAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3500 NW 56TH ST |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731124517 |
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 |
49 |
Number Of Services |
868 |
Number Of Medicare Beneficiaries |
231 |
Total Submitted Charge Amount |
102242 |
Total Medicare Allowed Amount |
52312.7 |
Total Medicare Payment Amount |
35865.56 |
Total Medicare Standardized Payment Amount |
39228.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
67 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
1614 |
Total Drug Medicare AllowedAmount |
1042.01 |
Total Drug Medicare PaymentAmount |
1004.15 |
Total Drug Medicare Standardized Payment Amount |
1004.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
801 |
Number Of Medicare Beneficiaries With Medical Services |
231 |
Total Medical Submitted Charge Amount |
100628 |
Total Medical Medicare Allowed Amount |
51270.69 |
Total Medical Medicare Payment Amount |
34861.41 |
Total Medical Medicare Standardized Payment Amount |
38224.55 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5667 |