National Provider Identifier [NPI]: |
1225469976 |
Last Name Of The Provider |
OGUNMUYIWA |
First Name Of The Provider |
MUMINOT |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4423 PASADA LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROUND ROCK |
Zip Code Of The Provider |
786811683 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1964 |
Number Of Medicare Beneficiaries |
625 |
Total Submitted Charge Amount |
368116.32 |
Total Medicare Allowed Amount |
207176.45 |
Total Medicare Payment Amount |
160555.57 |
Total Medicare Standardized Payment Amount |
191048 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
488.56 |
Total Drug Medicare AllowedAmount |
373.24 |
Total Drug Medicare PaymentAmount |
365.8 |
Total Drug Medicare Standardized Payment Amount |
365.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
1933 |
Number Of Medicare Beneficiaries With Medical Services |
625 |
Total Medical Submitted Charge Amount |
367627.76 |
Total Medical Medicare Allowed Amount |
206803.21 |
Total Medical Medicare Payment Amount |
160189.77 |
Total Medical Medicare Standardized Payment Amount |
190682.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
217 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
127 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
125 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
114 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
330 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2962 |