| National Provider Identifier [NPI]: | 1962402321 |
| Last Name Of The Provider | IKEGUCHI |
| First Name Of The Provider | ALEXANDRA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 920 STANTON L YOUNG BLVD |
| Street Address 2 Of The Provider | WP 2040 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731045033 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 18585 |
| Number Of Medicare Beneficiaries | 385 |
| Total Submitted Charge Amount | 1072243 |
| Total Medicare Allowed Amount | 386642.78 |
| Total Medicare Payment Amount | 297348.31 |
| Total Medicare Standardized Payment Amount | 297982.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 54 |
| Number Of Drug Services | 17366 |
| Number Of Medicare Beneficiaries With Drug Services | 158 |
| Total Drug Submitted ChargeAmount | 780713 |
| Total Drug Medicare AllowedAmount | 299201.35 |
| Total Drug Medicare PaymentAmount | 231878.37 |
| Total Drug Medicare Standardized Payment Amount | 231878.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 1219 |
| Number Of Medicare Beneficiaries With Medical Services | 385 |
| Total Medical Submitted Charge Amount | 291530 |
| Total Medical Medicare Allowed Amount | 87441.43 |
| Total Medical Medicare Payment Amount | 65469.94 |
| Total Medical Medicare Standardized Payment Amount | 66103.83 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 239 |
| Number Of Male Beneficiaries | 146 |
| Number Of Non Hispanic White Beneficiaries | 293 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 300 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0568 |