National Provider Identifier [NPI]: |
1760589303 |
Last Name Of The Provider |
ADEWUYI |
First Name Of The Provider |
ADEREMI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
632 MUSTANG RIDGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MURPHY |
Zip Code Of The Provider |
750944208 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
632 |
Number Of Medicare Beneficiaries |
410 |
Total Submitted Charge Amount |
701450 |
Total Medicare Allowed Amount |
70351.12 |
Total Medicare Payment Amount |
54010.44 |
Total Medicare Standardized Payment Amount |
55687.65 |
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 |
25 |
Number Of Medical Services |
632 |
Number Of Medicare Beneficiaries With Medical Services |
410 |
Total Medical Submitted Charge Amount |
701450 |
Total Medical Medicare Allowed Amount |
70351.12 |
Total Medical Medicare Payment Amount |
54010.44 |
Total Medical Medicare Standardized Payment Amount |
55687.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
383 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5531 |