National Provider Identifier [NPI]: |
1205834074 |
Last Name Of The Provider |
RICHARDSON |
First Name Of The Provider |
TYRUN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4 E CLARK BASS BLVD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
MCALESTER |
Zip Code Of The Provider |
745014269 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
1305 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
229215.05 |
Total Medicare Allowed Amount |
102348.82 |
Total Medicare Payment Amount |
76257.58 |
Total Medicare Standardized Payment Amount |
81084.56 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
324 |
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 |
276 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2309 |