National Provider Identifier [NPI]: |
1457349292 |
Last Name Of The Provider |
IFEDIORA |
First Name Of The Provider |
OKECHUKWU |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1908 ROYAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONROE |
Zip Code Of The Provider |
712015724 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1680 |
Number Of Medicare Beneficiaries |
507 |
Total Submitted Charge Amount |
467927 |
Total Medicare Allowed Amount |
209045.56 |
Total Medicare Payment Amount |
158365.13 |
Total Medicare Standardized Payment Amount |
165910.91 |
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 |
19 |
Number Of Medical Services |
1680 |
Number Of Medicare Beneficiaries With Medical Services |
507 |
Total Medical Submitted Charge Amount |
467927 |
Total Medical Medicare Allowed Amount |
209045.56 |
Total Medical Medicare Payment Amount |
158365.13 |
Total Medical Medicare Standardized Payment Amount |
165910.91 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
267 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
260 |
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 |
264 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
243 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
4.3833 |