National Provider Identifier [NPI]: |
1174672026 |
Last Name Of The Provider |
IKEZUAGU |
First Name Of The Provider |
OJIAKU |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
417 S EAST ST |
Street Address 2 Of The Provider |
SUITE #100 |
City Of The Provider |
CORYDON |
Zip Code Of The Provider |
500601860 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
210 |
Number Of Medicare Beneficiaries |
81 |
Total Submitted Charge Amount |
36231 |
Total Medicare Allowed Amount |
15596.5 |
Total Medicare Payment Amount |
12193.21 |
Total Medicare Standardized Payment Amount |
12861.07 |
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 |
14 |
Number Of Medical Services |
210 |
Number Of Medicare Beneficiaries With Medical Services |
81 |
Total Medical Submitted Charge Amount |
36231 |
Total Medical Medicare Allowed Amount |
15596.5 |
Total Medical Medicare Payment Amount |
12193.21 |
Total Medical Medicare Standardized Payment Amount |
12861.07 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
57 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4935 |