National Provider Identifier [NPI]: |
1194717132 |
Last Name Of The Provider |
FOSTER |
First Name Of The Provider |
DARLENE |
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 |
3330 NW 56TH ST |
Street Address 2 Of The Provider |
STE 604 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731124479 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1555 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
210600 |
Total Medicare Allowed Amount |
122974.98 |
Total Medicare Payment Amount |
94373.08 |
Total Medicare Standardized Payment Amount |
102939.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
77 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
2860 |
Total Drug Medicare AllowedAmount |
1833.4 |
Total Drug Medicare PaymentAmount |
1796.58 |
Total Drug Medicare Standardized Payment Amount |
1796.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
1478 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
207740 |
Total Medical Medicare Allowed Amount |
121141.58 |
Total Medical Medicare Payment Amount |
92576.5 |
Total Medical Medicare Standardized Payment Amount |
101142.8 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
201 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
233 |
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 |
250 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.024 |