| National Provider Identifier [NPI]: | 1558339911 |
| Last Name Of The Provider | GARRISON |
| First Name Of The Provider | VIRGINIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 940 NE 13TH ST |
| Street Address 2 Of The Provider | 4G4250 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731045008 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 7952 |
| Number Of Medicare Beneficiaries | 3636 |
| Total Submitted Charge Amount | 359006 |
| Total Medicare Allowed Amount | 78088.71 |
| Total Medicare Payment Amount | 59977.83 |
| Total Medicare Standardized Payment Amount | 63149.94 |
| 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 | 69 |
| Number Of Medical Services | 7952 |
| Number Of Medicare Beneficiaries With Medical Services | 3636 |
| Total Medical Submitted Charge Amount | 359006 |
| Total Medical Medicare Allowed Amount | 78088.71 |
| Total Medical Medicare Payment Amount | 59977.83 |
| Total Medical Medicare Standardized Payment Amount | 63149.94 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 1285 |
| Number Of Beneficiaries Age 65 to 74 | 1336 |
| Number Of Beneficiaries Age 75 to 84 | 757 |
| Number Of Beneficiaries Age Greater 84 | 258 |
| Number Of Female Beneficiaries | 2139 |
| Number Of Male Beneficiaries | 1497 |
| Number Of Non Hispanic White Beneficiaries | 2593 |
| Number Of Black or African American Beneficiaries | 663 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | 213 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2280 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1356 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9742 |