| National Provider Identifier [NPI]: | 1336347392 |
| Last Name Of The Provider | VICENA |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6585 S YALE AVE |
| Street Address 2 Of The Provider | SUITE 720 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741368384 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 5254 |
| Number Of Medicare Beneficiaries | 418 |
| Total Submitted Charge Amount | 542760.6 |
| Total Medicare Allowed Amount | 245500.09 |
| Total Medicare Payment Amount | 186316.1 |
| Total Medicare Standardized Payment Amount | 197661.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 3187 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 102087 |
| Total Drug Medicare AllowedAmount | 73830.26 |
| Total Drug Medicare PaymentAmount | 57580.13 |
| Total Drug Medicare Standardized Payment Amount | 57580.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 2067 |
| Number Of Medicare Beneficiaries With Medical Services | 418 |
| Total Medical Submitted Charge Amount | 440673.6 |
| Total Medical Medicare Allowed Amount | 171669.83 |
| Total Medical Medicare Payment Amount | 128735.97 |
| Total Medical Medicare Standardized Payment Amount | 140081.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 240 |
| Number Of Non Hispanic White Beneficiaries | 362 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 27 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2303 |