National Provider Identifier [NPI]: |
1558360370 |
Last Name Of The Provider |
AKAKABOTA |
First Name Of The Provider |
BOLANLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
515 WEKIVA COMMONS CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
APOPKA |
Zip Code Of The Provider |
327123645 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
495 |
Number Of Medicare Beneficiaries |
479 |
Total Submitted Charge Amount |
167420 |
Total Medicare Allowed Amount |
92965.34 |
Total Medicare Payment Amount |
70824.24 |
Total Medicare Standardized Payment Amount |
70659.13 |
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 |
7 |
Number Of Medical Services |
495 |
Number Of Medicare Beneficiaries With Medical Services |
479 |
Total Medical Submitted Charge Amount |
167420 |
Total Medical Medicare Allowed Amount |
92965.34 |
Total Medical Medicare Payment Amount |
70824.24 |
Total Medical Medicare Standardized Payment Amount |
70659.13 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
283 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
354 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
326 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2598 |