| National Provider Identifier [NPI]: | 1740371129 |
| Last Name Of The Provider | SEBASTIAN |
| First Name Of The Provider | VERONIQUE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4140 W MEMORIAL RD |
| Street Address 2 Of The Provider | #221 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731208366 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 440 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 35393.29 |
| Total Medicare Allowed Amount | 32505.75 |
| Total Medicare Payment Amount | 21705.84 |
| Total Medicare Standardized Payment Amount | 25182.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 440 |
| Number Of Medicare Beneficiaries With Medical Services | 117 |
| Total Medical Submitted Charge Amount | 35393.29 |
| Total Medical Medicare Allowed Amount | 32505.75 |
| Total Medical Medicare Payment Amount | 21705.84 |
| Total Medical Medicare Standardized Payment Amount | 25182.91 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | 0 |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 33 |
| Number Of Non Hispanic White Beneficiaries | 80 |
| 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 | 31 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 63 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 38 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.183 |