| National Provider Identifier [NPI]: | 1568689958 |
| Last Name Of The Provider | OKON |
| First Name Of The Provider | ANIETIE |
| 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 | 1100 MARSHALL WAY |
| Street Address 2 Of The Provider | MARSHALL MEDICAL CENTER |
| City Of The Provider | PLACERVILLE |
| Zip Code Of The Provider | 95667 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 214 |
| Number Of Services | 7376 |
| Number Of Medicare Beneficiaries | 3173 |
| Total Submitted Charge Amount | 913715 |
| Total Medicare Allowed Amount | 238009.1 |
| Total Medicare Payment Amount | 190025.41 |
| Total Medicare Standardized Payment Amount | 189507.37 |
| 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 | 214 |
| Number Of Medical Services | 7376 |
| Number Of Medicare Beneficiaries With Medical Services | 3173 |
| Total Medical Submitted Charge Amount | 913715 |
| Total Medical Medicare Allowed Amount | 238009.1 |
| Total Medical Medicare Payment Amount | 190025.41 |
| Total Medical Medicare Standardized Payment Amount | 189507.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 474 |
| Number Of Beneficiaries Age 65 to 74 | 1317 |
| Number Of Beneficiaries Age 75 to 84 | 911 |
| Number Of Beneficiaries Age Greater 84 | 471 |
| Number Of Female Beneficiaries | 2108 |
| Number Of Male Beneficiaries | 1065 |
| Number Of Non Hispanic White Beneficiaries | 2950 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | 31 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2545 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 628 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2285 |