National Provider Identifier [NPI]: |
1043231228 |
Last Name Of The Provider |
OGUNGBAMIGBE |
First Name Of The Provider |
THEOPHILUS |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
823 SW MULVANE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOPEKA |
Zip Code Of The Provider |
666061764 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
2552 |
Number Of Medicare Beneficiaries |
861 |
Total Submitted Charge Amount |
490647.44 |
Total Medicare Allowed Amount |
210388.26 |
Total Medicare Payment Amount |
156157.31 |
Total Medicare Standardized Payment Amount |
166300.87 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
187 |
Number Of Beneficiaries Age 65 to 74 |
313 |
Number Of Beneficiaries Age 75 to 84 |
256 |
Number Of Beneficiaries Age Greater 84 |
105 |
Number Of Female Beneficiaries |
447 |
Number Of Male Beneficiaries |
414 |
Number Of Non Hispanic White Beneficiaries |
711 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
623 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
58 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.9825 |