| National Provider Identifier [NPI]: | 1962738666 |
| Last Name Of The Provider | MBOH |
| First Name Of The Provider | HELEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1924 N. PORTLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OKLAHOMA |
| Zip Code Of The Provider | 73107 |
| 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 | 36 |
| Number Of Services | 967 |
| Number Of Medicare Beneficiaries | 79 |
| Total Submitted Charge Amount | 72137 |
| Total Medicare Allowed Amount | 30328.02 |
| Total Medicare Payment Amount | 22435.82 |
| Total Medicare Standardized Payment Amount | 23929.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1266 |
| Total Drug Medicare AllowedAmount | 459.24 |
| Total Drug Medicare PaymentAmount | 436.95 |
| Total Drug Medicare Standardized Payment Amount | 436.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 917 |
| Number Of Medicare Beneficiaries With Medical Services | 79 |
| Total Medical Submitted Charge Amount | 70871 |
| Total Medical Medicare Allowed Amount | 29868.78 |
| Total Medical Medicare Payment Amount | 21998.87 |
| Total Medical Medicare Standardized Payment Amount | 23493.02 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | 40 |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.29 |