| National Provider Identifier [NPI]: | 1811954589 |
| Last Name Of The Provider | BLOMGREN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 950 N PORTER |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | NORMAN |
| Zip Code Of The Provider | 730716410 |
| 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 | 46 |
| Number Of Services | 2247 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 160332.03 |
| Total Medicare Allowed Amount | 152098.59 |
| Total Medicare Payment Amount | 109990.49 |
| Total Medicare Standardized Payment Amount | 122988.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 226 |
| Number Of Medicare Beneficiaries With Drug Services | 155 |
| Total Drug Submitted ChargeAmount | 6728.38 |
| Total Drug Medicare AllowedAmount | 4584.37 |
| Total Drug Medicare PaymentAmount | 4371.97 |
| Total Drug Medicare Standardized Payment Amount | 4371.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2021 |
| Number Of Medicare Beneficiaries With Medical Services | 485 |
| Total Medical Submitted Charge Amount | 153603.65 |
| Total Medical Medicare Allowed Amount | 147514.22 |
| Total Medical Medicare Payment Amount | 105618.52 |
| Total Medical Medicare Standardized Payment Amount | 118616.72 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 244 |
| Number Of Beneficiaries Age 75 to 84 | 124 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 256 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 457 |
| 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 | 416 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0643 |