| National Provider Identifier [NPI]: | 1326033952 |
| Last Name Of The Provider | QUAINOO |
| First Name Of The Provider | EBENEZER |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3350 WILKENS AVE |
| Street Address 2 Of The Provider | SUITE 307 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212294600 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3219 |
| Number Of Medicare Beneficiaries | 193 |
| Total Submitted Charge Amount | 471335.9 |
| Total Medicare Allowed Amount | 274197.74 |
| Total Medicare Payment Amount | 208467.29 |
| Total Medicare Standardized Payment Amount | 195044.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 397 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 43067.5 |
| Total Drug Medicare AllowedAmount | 17969.27 |
| Total Drug Medicare PaymentAmount | 14556.3 |
| Total Drug Medicare Standardized Payment Amount | 14556.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2822 |
| Number Of Medicare Beneficiaries With Medical Services | 193 |
| Total Medical Submitted Charge Amount | 428268.4 |
| Total Medical Medicare Allowed Amount | 256228.47 |
| Total Medical Medicare Payment Amount | 193910.99 |
| Total Medical Medicare Standardized Payment Amount | 180488.27 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 103 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 79 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.889 |