| National Provider Identifier [NPI]: | 1801864319 |
| Last Name Of The Provider | PASQUE |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 NE 10TH ST |
| Street Address 2 Of The Provider | OUPB1300 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731045417 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 473 |
| Number Of Medicare Beneficiaries | 79 |
| Total Submitted Charge Amount | 189542 |
| Total Medicare Allowed Amount | 41732.77 |
| Total Medicare Payment Amount | 31427.15 |
| Total Medicare Standardized Payment Amount | 33764.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 318 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 4090 |
| Total Drug Medicare AllowedAmount | 2792.02 |
| Total Drug Medicare PaymentAmount | 2121.59 |
| Total Drug Medicare Standardized Payment Amount | 2121.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 155 |
| Number Of Medicare Beneficiaries With Medical Services | 79 |
| Total Medical Submitted Charge Amount | 185452 |
| Total Medical Medicare Allowed Amount | 38940.75 |
| Total Medical Medicare Payment Amount | 29305.56 |
| Total Medical Medicare Standardized Payment Amount | 31642.93 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 51 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | 59 |
| 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 | 61 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1601 |