| National Provider Identifier [NPI]: | 1003013723 |
| Last Name Of The Provider | FIELDS |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1705 E 19TH ST |
| Street Address 2 Of The Provider | STE 302 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741045405 |
| 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 | 20 |
| Number Of Services | 1036 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 214975 |
| Total Medicare Allowed Amount | 100320.39 |
| Total Medicare Payment Amount | 75509.59 |
| Total Medicare Standardized Payment Amount | 80911.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 1036 |
| Number Of Medicare Beneficiaries With Medical Services | 413 |
| Total Medical Submitted Charge Amount | 214975 |
| Total Medical Medicare Allowed Amount | 100320.39 |
| Total Medical Medicare Payment Amount | 75509.59 |
| Total Medical Medicare Standardized Payment Amount | 80911.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 130 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | 312 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 51 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0312 |