National Provider Identifier [NPI]: |
1710150941 |
Last Name Of The Provider |
NWAOKOLO |
First Name Of The Provider |
MAUREEN |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2701 N DECATUR RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
300335918 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1603 |
Number Of Medicare Beneficiaries |
470 |
Total Submitted Charge Amount |
410396 |
Total Medicare Allowed Amount |
160728.37 |
Total Medicare Payment Amount |
125982.55 |
Total Medicare Standardized Payment Amount |
130012.27 |
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 |
17 |
Number Of Medical Services |
1603 |
Number Of Medicare Beneficiaries With Medical Services |
470 |
Total Medical Submitted Charge Amount |
410396 |
Total Medical Medicare Allowed Amount |
160728.37 |
Total Medical Medicare Payment Amount |
125982.55 |
Total Medical Medicare Standardized Payment Amount |
130012.27 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
231 |
Number Of Non Hispanic White Beneficiaries |
429 |
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 |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2663 |