National Provider Identifier [NPI]: |
1295047918 |
Last Name Of The Provider |
OJELADE |
First Name Of The Provider |
OLUBUNMI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2602 SAINT MICHAEL DR |
Street Address 2 Of The Provider |
STE 302 |
City Of The Provider |
TEXARKANA |
Zip Code Of The Provider |
755032387 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1132 |
Number Of Medicare Beneficiaries |
461 |
Total Submitted Charge Amount |
381534 |
Total Medicare Allowed Amount |
123153.76 |
Total Medicare Payment Amount |
95619.69 |
Total Medicare Standardized Payment Amount |
99405.34 |
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 |
21 |
Number Of Medical Services |
1132 |
Number Of Medicare Beneficiaries With Medical Services |
461 |
Total Medical Submitted Charge Amount |
381534 |
Total Medical Medicare Allowed Amount |
123153.76 |
Total Medical Medicare Payment Amount |
95619.69 |
Total Medical Medicare Standardized Payment Amount |
99405.34 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
343 |
Number Of Black or African American Beneficiaries |
89 |
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
220 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1643 |