| National Provider Identifier [NPI]: | 1821322694 |
| Last Name Of The Provider | PACE |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1809 E 13TH ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741044419 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 2418 |
| Number Of Medicare Beneficiaries | 648 |
| Total Submitted Charge Amount | 518497.89 |
| Total Medicare Allowed Amount | 136406.26 |
| Total Medicare Payment Amount | 99695.59 |
| Total Medicare Standardized Payment Amount | 116114.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 588 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 11025 |
| Total Drug Medicare AllowedAmount | 4934.47 |
| Total Drug Medicare PaymentAmount | 3807.95 |
| Total Drug Medicare Standardized Payment Amount | 3807.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 1830 |
| Number Of Medicare Beneficiaries With Medical Services | 648 |
| Total Medical Submitted Charge Amount | 507472.89 |
| Total Medical Medicare Allowed Amount | 131471.79 |
| Total Medical Medicare Payment Amount | 95887.64 |
| Total Medical Medicare Standardized Payment Amount | 112306.91 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 400 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 507 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 76 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 488 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2865 |