| National Provider Identifier [NPI]: | 1568677565 |
| Last Name Of The Provider | WASHBURN |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 819 E DEWEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAPULPA |
| Zip Code Of The Provider | 740664458 |
| 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 | 28 |
| Number Of Services | 2236 |
| Number Of Medicare Beneficiaries | 1014 |
| Total Submitted Charge Amount | 114839.34 |
| Total Medicare Allowed Amount | 92045.88 |
| Total Medicare Payment Amount | 60987.04 |
| Total Medicare Standardized Payment Amount | 66033.72 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 497 |
| Number Of Female Beneficiaries | 751 |
| Number Of Male Beneficiaries | 263 |
| Number Of Non Hispanic White Beneficiaries | 867 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 64 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 557 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9761 |