| National Provider Identifier [NPI]: | 1114066180 |
| Last Name Of The Provider | STIDHAM |
| First Name Of The Provider | ANNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 EVERETT DR |
| Street Address 2 Of The Provider | 1 NP 606 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731045047 |
| 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 | 183 |
| Number Of Services | 5555 |
| Number Of Medicare Beneficiaries | 3788 |
| Total Submitted Charge Amount | 439834.6 |
| Total Medicare Allowed Amount | 149173.55 |
| Total Medicare Payment Amount | 113625.71 |
| Total Medicare Standardized Payment Amount | 120680.28 |
| 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 | 183 |
| Number Of Medical Services | 5555 |
| Number Of Medicare Beneficiaries With Medical Services | 3788 |
| Total Medical Submitted Charge Amount | 439834.6 |
| Total Medical Medicare Allowed Amount | 149173.55 |
| Total Medical Medicare Payment Amount | 113625.71 |
| Total Medical Medicare Standardized Payment Amount | 120680.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 740 |
| Number Of Beneficiaries Age 65 to 74 | 1409 |
| Number Of Beneficiaries Age 75 to 84 | 1081 |
| Number Of Beneficiaries Age Greater 84 | 558 |
| Number Of Female Beneficiaries | 2402 |
| Number Of Male Beneficiaries | 1386 |
| Number Of Non Hispanic White Beneficiaries | 3035 |
| Number Of Black or African American Beneficiaries | 241 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | 416 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2688 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1100 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5691 |