| National Provider Identifier [NPI]: | 1619940152 |
| Last Name Of The Provider | ROMAN |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2605 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JENKS |
| Zip Code Of The Provider | 740373429 |
| 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 | 30 |
| Number Of Services | 991 |
| Number Of Medicare Beneficiaries | 246 |
| Total Submitted Charge Amount | 119829 |
| Total Medicare Allowed Amount | 62930.87 |
| Total Medicare Payment Amount | 41177.55 |
| Total Medicare Standardized Payment Amount | 45829.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 170 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 3362 |
| Total Drug Medicare AllowedAmount | 2222.85 |
| Total Drug Medicare PaymentAmount | 2142.29 |
| Total Drug Medicare Standardized Payment Amount | 2142.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 821 |
| Number Of Medicare Beneficiaries With Medical Services | 246 |
| Total Medical Submitted Charge Amount | 116467 |
| Total Medical Medicare Allowed Amount | 60708.02 |
| Total Medical Medicare Payment Amount | 39035.26 |
| Total Medical Medicare Standardized Payment Amount | 43687.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 222 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1117 |