| National Provider Identifier [NPI]: | 1902809080 |
| Last Name Of The Provider | REVELIS |
| First Name Of The Provider | ANDREAS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 S WHEELING AVE |
| Street Address 2 Of The Provider | STE 600 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741045645 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 36537 |
| Number Of Medicare Beneficiaries | 1832 |
| Total Submitted Charge Amount | 3640258.11 |
| Total Medicare Allowed Amount | 1184347.67 |
| Total Medicare Payment Amount | 908155.4 |
| Total Medicare Standardized Payment Amount | 828497.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 28628 |
| Number Of Medicare Beneficiaries With Drug Services | 910 |
| Total Drug Submitted ChargeAmount | 75790.11 |
| Total Drug Medicare AllowedAmount | 4158.33 |
| Total Drug Medicare PaymentAmount | 3253.21 |
| Total Drug Medicare Standardized Payment Amount | 3253.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 7909 |
| Number Of Medicare Beneficiaries With Medical Services | 1831 |
| Total Medical Submitted Charge Amount | 3564468 |
| Total Medical Medicare Allowed Amount | 1180189.34 |
| Total Medical Medicare Payment Amount | 904902.19 |
| Total Medical Medicare Standardized Payment Amount | 825244.5 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 942 |
| Number Of Beneficiaries Age 65 to 74 | 575 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 1157 |
| Number Of Male Beneficiaries | 675 |
| Number Of Non Hispanic White Beneficiaries | 1338 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 330 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1029 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 803 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3322 |