| National Provider Identifier [NPI]: | 1912941485 |
| Last Name Of The Provider | REBURN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 E FRANK PHILLIPS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARTLESVILLE |
| Zip Code Of The Provider | 740062411 |
| 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 | 244 |
| Number Of Services | 7875 |
| Number Of Medicare Beneficiaries | 4479 |
| Total Submitted Charge Amount | 973637.84 |
| Total Medicare Allowed Amount | 229860.53 |
| Total Medicare Payment Amount | 170916.78 |
| Total Medicare Standardized Payment Amount | 181606.44 |
| 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 | 244 |
| Number Of Medical Services | 7875 |
| Number Of Medicare Beneficiaries With Medical Services | 4479 |
| Total Medical Submitted Charge Amount | 973637.84 |
| Total Medical Medicare Allowed Amount | 229860.53 |
| Total Medical Medicare Payment Amount | 170916.78 |
| Total Medical Medicare Standardized Payment Amount | 181606.44 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 821 |
| Number Of Beneficiaries Age 65 to 74 | 1551 |
| Number Of Beneficiaries Age 75 to 84 | 1364 |
| Number Of Beneficiaries Age Greater 84 | 743 |
| Number Of Female Beneficiaries | 2840 |
| Number Of Male Beneficiaries | 1639 |
| Number Of Non Hispanic White Beneficiaries | 3855 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 465 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1121 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.325 |