| National Provider Identifier [NPI]: | 1497001549 |
| Last Name Of The Provider | ODAWO |
| First Name Of The Provider | EVELYN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 131 CONTINENTAL DR |
| Street Address 2 Of The Provider | SUITE 410 |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 197134305 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1639 |
| Number Of Medicare Beneficiaries | 557 |
| Total Submitted Charge Amount | 167652.61 |
| Total Medicare Allowed Amount | 164072.01 |
| Total Medicare Payment Amount | 124906.23 |
| Total Medicare Standardized Payment Amount | 124127.46 |
| 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 | 20 |
| Number Of Medical Services | 1639 |
| Number Of Medicare Beneficiaries With Medical Services | 557 |
| Total Medical Submitted Charge Amount | 167652.61 |
| Total Medical Medicare Allowed Amount | 164072.01 |
| Total Medical Medicare Payment Amount | 124906.23 |
| Total Medical Medicare Standardized Payment Amount | 124127.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 293 |
| Number Of Male Beneficiaries | 264 |
| Number Of Non Hispanic White Beneficiaries | 417 |
| Number Of Black or African American Beneficiaries | 115 |
| 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 | 376 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5258 |