| National Provider Identifier [NPI]: | 1073562419 |
| Last Name Of The Provider | ODELOWO |
| First Name Of The Provider | MOBOLAJI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | SUITE 118 |
| City Of The Provider | CONROE |
| Zip Code Of The Provider | 773042888 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 16767 |
| Number Of Medicare Beneficiaries | 605 |
| Total Submitted Charge Amount | 8334862.81 |
| Total Medicare Allowed Amount | 1259274.21 |
| Total Medicare Payment Amount | 983510.45 |
| Total Medicare Standardized Payment Amount | 1021731.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 13432 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 136860 |
| Total Drug Medicare AllowedAmount | 23219.12 |
| Total Drug Medicare PaymentAmount | 18203.82 |
| Total Drug Medicare Standardized Payment Amount | 18203.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 3335 |
| Number Of Medicare Beneficiaries With Medical Services | 605 |
| Total Medical Submitted Charge Amount | 8198002.81 |
| Total Medical Medicare Allowed Amount | 1236055.09 |
| Total Medical Medicare Payment Amount | 965306.63 |
| Total Medical Medicare Standardized Payment Amount | 1003527.73 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 238 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 482 |
| Number Of Black or African American Beneficiaries | 78 |
| 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 | 436 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 3.1155 |