| National Provider Identifier [NPI]: | 1124016506 |
| Last Name Of The Provider | OKINO |
| First Name Of The Provider | DICK |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 915 TOLL HOUSE AVE |
| Street Address 2 Of The Provider | #207 |
| City Of The Provider | FREDERICK |
| Zip Code Of The Provider | 217015930 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 5851 |
| Number Of Medicare Beneficiaries | 950 |
| Total Submitted Charge Amount | 298712 |
| Total Medicare Allowed Amount | 214765.99 |
| Total Medicare Payment Amount | 153798.23 |
| Total Medicare Standardized Payment Amount | 149881.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 72 |
| Total Drug Medicare AllowedAmount | 42.83 |
| Total Drug Medicare PaymentAmount | 29.99 |
| Total Drug Medicare Standardized Payment Amount | 29.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 5827 |
| Number Of Medicare Beneficiaries With Medical Services | 950 |
| Total Medical Submitted Charge Amount | 298640 |
| Total Medical Medicare Allowed Amount | 214723.16 |
| Total Medical Medicare Payment Amount | 153768.24 |
| Total Medical Medicare Standardized Payment Amount | 149851.96 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 303 |
| Number Of Beneficiaries Age Greater 84 | 512 |
| Number Of Female Beneficiaries | 657 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 915 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 797 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6829 |