| National Provider Identifier [NPI]: | 1669644589 |
| Last Name Of The Provider | AJIBOLA |
| First Name Of The Provider | BAMIDELE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAWRENCEVILLE |
| Zip Code Of The Provider | 300467694 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 1019 |
| Number Of Medicare Beneficiaries | 686 |
| Total Submitted Charge Amount | 340690 |
| Total Medicare Allowed Amount | 147628.09 |
| Total Medicare Payment Amount | 114877.76 |
| Total Medicare Standardized Payment Amount | 116991.52 |
| 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 | 17 |
| Number Of Medical Services | 1019 |
| Number Of Medicare Beneficiaries With Medical Services | 686 |
| Total Medical Submitted Charge Amount | 340690 |
| Total Medical Medicare Allowed Amount | 147628.09 |
| Total Medical Medicare Payment Amount | 114877.76 |
| Total Medical Medicare Standardized Payment Amount | 116991.52 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 405 |
| Number Of Male Beneficiaries | 281 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | 160 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 455 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 231 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.7952 |