National Provider Identifier [NPI]: |
1679736862 |
Last Name Of The Provider |
OBADINA |
First Name Of The Provider |
ENIOLA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
825 EASTLAKE AVE E |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981094405 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1537 |
Number Of Medicare Beneficiaries |
756 |
Total Submitted Charge Amount |
335856.86 |
Total Medicare Allowed Amount |
111330.73 |
Total Medicare Payment Amount |
99408.92 |
Total Medicare Standardized Payment Amount |
93044.12 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
415 |
Number Of Beneficiaries Age 75 to 84 |
211 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
703 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
601 |
Number Of Black or African American Beneficiaries |
98 |
Number Of AsianPacific Islander Beneficiaries |
30 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
670 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1421 |