| National Provider Identifier [NPI]: | 1467688176 |
| Last Name Of The Provider | MAKORI |
| First Name Of The Provider | FREDRICK |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 905 DIXIE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 301174417 |
| 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 | 38 |
| Number Of Services | 1064 |
| Number Of Medicare Beneficiaries | 314 |
| Total Submitted Charge Amount | 109224 |
| Total Medicare Allowed Amount | 68918.23 |
| Total Medicare Payment Amount | 46484.5 |
| Total Medicare Standardized Payment Amount | 50651.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 161 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 3948 |
| Total Drug Medicare AllowedAmount | 1832.73 |
| Total Drug Medicare PaymentAmount | 1691.78 |
| Total Drug Medicare Standardized Payment Amount | 1691.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 903 |
| Number Of Medicare Beneficiaries With Medical Services | 314 |
| Total Medical Submitted Charge Amount | 105276 |
| Total Medical Medicare Allowed Amount | 67085.5 |
| Total Medical Medicare Payment Amount | 44792.72 |
| Total Medical Medicare Standardized Payment Amount | 48959.52 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 254 |
| Number Of Black or African American Beneficiaries | |
| 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 | 185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2553 |