National Provider Identifier [NPI]: |
1316032675 |
Last Name Of The Provider |
AKOMOLAFE |
First Name Of The Provider |
BABATUNDE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PT, DPT, GCS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11351 JAMES WATT DR |
Street Address 2 Of The Provider |
STE. A |
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799366627 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1960 |
Number Of Medicare Beneficiaries |
43 |
Total Submitted Charge Amount |
67786.42 |
Total Medicare Allowed Amount |
47483.8 |
Total Medicare Payment Amount |
36988.03 |
Total Medicare Standardized Payment Amount |
28016.42 |
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 |
12 |
Number Of Medical Services |
1960 |
Number Of Medicare Beneficiaries With Medical Services |
43 |
Total Medical Submitted Charge Amount |
67786.42 |
Total Medical Medicare Allowed Amount |
47483.8 |
Total Medical Medicare Payment Amount |
36988.03 |
Total Medical Medicare Standardized Payment Amount |
28016.42 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
15 |
Number Of Beneficiaries Age 75 to 84 |
15 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
20 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1633 |