| National Provider Identifier [NPI]: | 1003814179 |
| Last Name Of The Provider | DAVID |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 E. 13TH ST. |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | GROVE |
| Zip Code Of The Provider | 743442962 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 6875 |
| Number Of Medicare Beneficiaries | 633 |
| Total Submitted Charge Amount | 587329 |
| Total Medicare Allowed Amount | 308576.47 |
| Total Medicare Payment Amount | 218747.34 |
| Total Medicare Standardized Payment Amount | 237835.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 2518 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 65748 |
| Total Drug Medicare AllowedAmount | 35101.62 |
| Total Drug Medicare PaymentAmount | 27684.72 |
| Total Drug Medicare Standardized Payment Amount | 27684.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4357 |
| Number Of Medicare Beneficiaries With Medical Services | 633 |
| Total Medical Submitted Charge Amount | 521581 |
| Total Medical Medicare Allowed Amount | 273474.85 |
| Total Medical Medicare Payment Amount | 191062.62 |
| Total Medical Medicare Standardized Payment Amount | 210150.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 313 |
| Number Of Male Beneficiaries | 320 |
| Number Of Non Hispanic White Beneficiaries | 561 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 442 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3978 |