| National Provider Identifier [NPI]: | 1801883400 |
| Last Name Of The Provider | CLOUSER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4111 S DARLINGTON AVE |
| Street Address 2 Of The Provider | STE 700 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741356348 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 7053 |
| Number Of Medicare Beneficiaries | 4978 |
| Total Submitted Charge Amount | 569039 |
| Total Medicare Allowed Amount | 185816.03 |
| Total Medicare Payment Amount | 140216.1 |
| Total Medicare Standardized Payment Amount | 148954.35 |
| 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 | 157 |
| Number Of Medical Services | 7053 |
| Number Of Medicare Beneficiaries With Medical Services | 4978 |
| Total Medical Submitted Charge Amount | 569039 |
| Total Medical Medicare Allowed Amount | 185816.03 |
| Total Medical Medicare Payment Amount | 140216.1 |
| Total Medical Medicare Standardized Payment Amount | 148954.35 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 921 |
| Number Of Beneficiaries Age 65 to 74 | 1933 |
| Number Of Beneficiaries Age 75 to 84 | 1400 |
| Number Of Beneficiaries Age Greater 84 | 724 |
| Number Of Female Beneficiaries | 2798 |
| Number Of Male Beneficiaries | 2180 |
| Number Of Non Hispanic White Beneficiaries | 4151 |
| Number Of Black or African American Beneficiaries | 277 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 415 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3961 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1017 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.662 |