| National Provider Identifier [NPI]: | 1306808027 |
| Last Name Of The Provider | FIELDS |
| First Name Of The Provider | MARTHA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1401 E VAN BUREN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCALESTER |
| Zip Code Of The Provider | 745014245 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 200 |
| Number Of Medicare Beneficiaries | 76 |
| Total Submitted Charge Amount | 9292.85 |
| Total Medicare Allowed Amount | 6569.21 |
| Total Medicare Payment Amount | 4501.23 |
| Total Medicare Standardized Payment Amount | 5787.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 313.51 |
| Total Drug Medicare AllowedAmount | 170.84 |
| Total Drug Medicare PaymentAmount | 99.93 |
| Total Drug Medicare Standardized Payment Amount | 99.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 129 |
| Number Of Medicare Beneficiaries With Medical Services | 76 |
| Total Medical Submitted Charge Amount | 8979.34 |
| Total Medical Medicare Allowed Amount | 6398.37 |
| Total Medical Medicare Payment Amount | 4401.3 |
| Total Medical Medicare Standardized Payment Amount | 5687.55 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 51 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8262 |