| National Provider Identifier [NPI]: | 1427004993 |
| Last Name Of The Provider | NOLLEY |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 S 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENID |
| Zip Code Of The Provider | 737015832 |
| 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 | 175 |
| Number Of Services | 4972 |
| Number Of Medicare Beneficiaries | 2628 |
| Total Submitted Charge Amount | 547478.65 |
| Total Medicare Allowed Amount | 161404.35 |
| Total Medicare Payment Amount | 116412.52 |
| Total Medicare Standardized Payment Amount | 123466.07 |
| 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 | 175 |
| Number Of Medical Services | 4972 |
| Number Of Medicare Beneficiaries With Medical Services | 2628 |
| Total Medical Submitted Charge Amount | 547478.65 |
| Total Medical Medicare Allowed Amount | 161404.35 |
| Total Medical Medicare Payment Amount | 116412.52 |
| Total Medical Medicare Standardized Payment Amount | 123466.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 375 |
| Number Of Beneficiaries Age 65 to 74 | 939 |
| Number Of Beneficiaries Age 75 to 84 | 885 |
| Number Of Beneficiaries Age Greater 84 | 429 |
| Number Of Female Beneficiaries | 1515 |
| Number Of Male Beneficiaries | 1113 |
| Number Of Non Hispanic White Beneficiaries | 2484 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 45 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2162 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 466 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5029 |