National Provider Identifier [NPI]: |
1659574135 |
Last Name Of The Provider |
ADEKILE |
First Name Of The Provider |
AYOOLA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 S RANCHO DR |
Street Address 2 Of The Provider |
SUITE 12 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891064844 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3044 |
Number Of Medicare Beneficiaries |
594 |
Total Submitted Charge Amount |
677010 |
Total Medicare Allowed Amount |
213518.2 |
Total Medicare Payment Amount |
157690.74 |
Total Medicare Standardized Payment Amount |
159121.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
997 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
2860 |
Total Drug Medicare AllowedAmount |
1087.32 |
Total Drug Medicare PaymentAmount |
885.55 |
Total Drug Medicare Standardized Payment Amount |
885.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
2047 |
Number Of Medicare Beneficiaries With Medical Services |
594 |
Total Medical Submitted Charge Amount |
674150 |
Total Medical Medicare Allowed Amount |
212430.88 |
Total Medical Medicare Payment Amount |
156805.19 |
Total Medical Medicare Standardized Payment Amount |
158236.08 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
268 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
260 |
Number Of Male Beneficiaries |
334 |
Number Of Non Hispanic White Beneficiaries |
264 |
Number Of Black or African American Beneficiaries |
136 |
Number Of AsianPacific Islander Beneficiaries |
55 |
Number Of Hispanic Beneficiaries |
117 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
372 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
222 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
4.3976 |