| National Provider Identifier [NPI]: | 1568430007 |
| Last Name Of The Provider | MANNEL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 NE 10TH ST |
| Street Address 2 Of The Provider | OUPB5200 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731045417 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gynecological/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 22336 |
| Number Of Medicare Beneficiaries | 329 |
| Total Submitted Charge Amount | 1298464 |
| Total Medicare Allowed Amount | 461525.48 |
| Total Medicare Payment Amount | 360563.03 |
| Total Medicare Standardized Payment Amount | 363047.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 57 |
| Number Of Drug Services | 21109 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 898681 |
| Total Drug Medicare AllowedAmount | 359537 |
| Total Drug Medicare PaymentAmount | 281717.82 |
| Total Drug Medicare Standardized Payment Amount | 281717.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 1227 |
| Number Of Medicare Beneficiaries With Medical Services | 329 |
| Total Medical Submitted Charge Amount | 399783 |
| Total Medical Medicare Allowed Amount | 101988.48 |
| Total Medical Medicare Payment Amount | 78845.21 |
| Total Medical Medicare Standardized Payment Amount | 81329.99 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 259 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | 283 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.9355 |