| National Provider Identifier [NPI]: | 1942496096 |
| Last Name Of The Provider | OLUBI |
| First Name Of The Provider | OLUYEMISI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1510 TURQOISE ROAD |
| Street Address 2 Of The Provider | BULLHEAD CITY CLINIC CORPORATION/ SILVER CREEK FAMILY P |
| City Of The Provider | BULLHEAD CITY |
| Zip Code Of The Provider | 86442 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 325 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 53931 |
| Total Medicare Allowed Amount | 21374.04 |
| Total Medicare Payment Amount | 11079.9 |
| Total Medicare Standardized Payment Amount | 11213.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 314 |
| Total Drug Medicare AllowedAmount | 68.1 |
| Total Drug Medicare PaymentAmount | 49.66 |
| Total Drug Medicare Standardized Payment Amount | 49.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 311 |
| Number Of Medicare Beneficiaries With Medical Services | 154 |
| Total Medical Submitted Charge Amount | 53617 |
| Total Medical Medicare Allowed Amount | 21305.94 |
| Total Medical Medicare Payment Amount | 11030.24 |
| Total Medical Medicare Standardized Payment Amount | 11164.15 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | 135 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0125 |