| National Provider Identifier [NPI]: | 1619966108 |
| Last Name Of The Provider | RADER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1121 W 3RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELK CITY |
| Zip Code Of The Provider | 736445103 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 10198 |
| Number Of Medicare Beneficiaries | 1463 |
| Total Submitted Charge Amount | 464464.38 |
| Total Medicare Allowed Amount | 458911.74 |
| Total Medicare Payment Amount | 321556.01 |
| Total Medicare Standardized Payment Amount | 342157.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 18194.3 |
| Total Drug Medicare AllowedAmount | 18097.65 |
| Total Drug Medicare PaymentAmount | 14059.67 |
| Total Drug Medicare Standardized Payment Amount | 14059.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 10124 |
| Number Of Medicare Beneficiaries With Medical Services | 1463 |
| Total Medical Submitted Charge Amount | 446270.08 |
| Total Medical Medicare Allowed Amount | 440814.09 |
| Total Medical Medicare Payment Amount | 307496.34 |
| Total Medical Medicare Standardized Payment Amount | 328097.45 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 536 |
| Number Of Beneficiaries Age 75 to 84 | 626 |
| Number Of Beneficiaries Age Greater 84 | 272 |
| Number Of Female Beneficiaries | 709 |
| Number Of Male Beneficiaries | 754 |
| Number Of Non Hispanic White Beneficiaries | 1427 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9096 |