National Provider Identifier [NPI]: |
1477713691 |
Last Name Of The Provider |
LOBB |
First Name Of The Provider |
KELLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
950 N PORTER |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
NORMAN |
Zip Code Of The Provider |
730716410 |
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 |
38 |
Number Of Services |
1278 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
90207.87 |
Total Medicare Allowed Amount |
85104.95 |
Total Medicare Payment Amount |
60112.29 |
Total Medicare Standardized Payment Amount |
67220.53 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
203 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
4797.27 |
Total Drug Medicare AllowedAmount |
2654.78 |
Total Drug Medicare PaymentAmount |
2520.95 |
Total Drug Medicare Standardized Payment Amount |
2520.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1075 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
85410.6 |
Total Medical Medicare Allowed Amount |
82450.17 |
Total Medical Medicare Payment Amount |
57591.34 |
Total Medical Medicare Standardized Payment Amount |
64699.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
241 |
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 |
225 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.0525 |