| National Provider Identifier [NPI]: | 1124214945 |
| Last Name Of The Provider | SKINNER |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2224 NW 50TH ST |
| Street Address 2 Of The Provider | SUITE 276W |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731128046 |
| 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 | 174 |
| Number Of Services | 8519 |
| Number Of Medicare Beneficiaries | 4114 |
| Total Submitted Charge Amount | 713510 |
| Total Medicare Allowed Amount | 192437.44 |
| Total Medicare Payment Amount | 148792.58 |
| Total Medicare Standardized Payment Amount | 157501.71 |
| 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 | 174 |
| Number Of Medical Services | 8519 |
| Number Of Medicare Beneficiaries With Medical Services | 4114 |
| Total Medical Submitted Charge Amount | 713510 |
| Total Medical Medicare Allowed Amount | 192437.44 |
| Total Medical Medicare Payment Amount | 148792.58 |
| Total Medical Medicare Standardized Payment Amount | 157501.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 765 |
| Number Of Beneficiaries Age 65 to 74 | 1579 |
| Number Of Beneficiaries Age 75 to 84 | 1230 |
| Number Of Beneficiaries Age Greater 84 | 540 |
| Number Of Female Beneficiaries | 2642 |
| Number Of Male Beneficiaries | 1472 |
| Number Of Non Hispanic White Beneficiaries | 3537 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 371 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2960 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1154 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4447 |