| National Provider Identifier [NPI]: | 1477677458 |
| Last Name Of The Provider | OLUWATADE |
| First Name Of The Provider | OLATUNJI |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2080 S, FRONTAGE RD. |
| Street Address 2 Of The Provider | SUITE100 |
| City Of The Provider | VICKSBURG |
| Zip Code Of The Provider | 391805883 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1984 |
| Number Of Medicare Beneficiaries | 609 |
| Total Submitted Charge Amount | 560724 |
| Total Medicare Allowed Amount | 198811.46 |
| Total Medicare Payment Amount | 152744.79 |
| Total Medicare Standardized Payment Amount | 164562.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 400 |
| Total Drug Medicare AllowedAmount | 250.74 |
| Total Drug Medicare PaymentAmount | 245.66 |
| Total Drug Medicare Standardized Payment Amount | 245.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1973 |
| Number Of Medicare Beneficiaries With Medical Services | 609 |
| Total Medical Submitted Charge Amount | 560324 |
| Total Medical Medicare Allowed Amount | 198560.72 |
| Total Medical Medicare Payment Amount | 152499.13 |
| Total Medical Medicare Standardized Payment Amount | 164316.6 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 175 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 335 |
| 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 | 258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 351 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.541 |