| National Provider Identifier [NPI]: | 1801075759 |
| Last Name Of The Provider | MALINE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N LEE AVE |
| Street Address 2 Of The Provider | #4803 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731021036 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 3493 |
| Number Of Medicare Beneficiaries | 425 |
| Total Submitted Charge Amount | 455970 |
| Total Medicare Allowed Amount | 197794.88 |
| Total Medicare Payment Amount | 149427.4 |
| Total Medicare Standardized Payment Amount | 163640.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2017 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 37644 |
| Total Drug Medicare AllowedAmount | 23241.23 |
| Total Drug Medicare PaymentAmount | 18162.98 |
| Total Drug Medicare Standardized Payment Amount | 18162.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 1476 |
| Number Of Medicare Beneficiaries With Medical Services | 425 |
| Total Medical Submitted Charge Amount | 418326 |
| Total Medical Medicare Allowed Amount | 174553.65 |
| Total Medical Medicare Payment Amount | 131264.42 |
| Total Medical Medicare Standardized Payment Amount | 145477.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 152 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 283 |
| Number Of Male Beneficiaries | 142 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| 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 | 373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2068 |