| National Provider Identifier [NPI]: | 1518977628 |
| Last Name Of The Provider | MENZ |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20912 SE 29TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRAH |
| Zip Code Of The Provider | 730456439 |
| 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 | 50 |
| Number Of Services | 4287 |
| Number Of Medicare Beneficiaries | 420 |
| Total Submitted Charge Amount | 144959.89 |
| Total Medicare Allowed Amount | 140647.14 |
| Total Medicare Payment Amount | 99184.29 |
| Total Medicare Standardized Payment Amount | 112097.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1284 |
| Number Of Medicare Beneficiaries With Drug Services | 136 |
| Total Drug Submitted ChargeAmount | 1778.64 |
| Total Drug Medicare AllowedAmount | 1545.89 |
| Total Drug Medicare PaymentAmount | 1415.96 |
| Total Drug Medicare Standardized Payment Amount | 1415.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3003 |
| Number Of Medicare Beneficiaries With Medical Services | 420 |
| Total Medical Submitted Charge Amount | 143181.25 |
| Total Medical Medicare Allowed Amount | 139101.25 |
| Total Medical Medicare Payment Amount | 97768.33 |
| Total Medical Medicare Standardized Payment Amount | 110681.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 198 |
| Number Of Non Hispanic White Beneficiaries | 409 |
| Number Of Black or African American Beneficiaries | |
| 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 | 395 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9894 |