| National Provider Identifier [NPI]: | 1740238625 |
| Last Name Of The Provider | HASLAM |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N LEE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731021036 |
| 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 | 180 |
| Number Of Services | 6613 |
| Number Of Medicare Beneficiaries | 4419 |
| Total Submitted Charge Amount | 618665 |
| Total Medicare Allowed Amount | 162672.56 |
| Total Medicare Payment Amount | 124233.02 |
| Total Medicare Standardized Payment Amount | 133144.17 |
| 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 | 180 |
| Number Of Medical Services | 6613 |
| Number Of Medicare Beneficiaries With Medical Services | 4419 |
| Total Medical Submitted Charge Amount | 618665 |
| Total Medical Medicare Allowed Amount | 162672.56 |
| Total Medical Medicare Payment Amount | 124233.02 |
| Total Medical Medicare Standardized Payment Amount | 133144.17 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 974 |
| Number Of Beneficiaries Age 65 to 74 | 1632 |
| Number Of Beneficiaries Age 75 to 84 | 1242 |
| Number Of Beneficiaries Age Greater 84 | 571 |
| Number Of Female Beneficiaries | 2658 |
| Number Of Male Beneficiaries | 1761 |
| Number Of Non Hispanic White Beneficiaries | 3560 |
| Number Of Black or African American Beneficiaries | 407 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 111 |
| Number Of American Indian Alaska Native Beneficiaries | 276 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3045 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1374 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6161 |