National Provider Identifier [NPI]: |
1679522023 |
Last Name Of The Provider |
JAGUN |
First Name Of The Provider |
OLABISI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12600 HILL CREEK LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
POTOMAC |
Zip Code Of The Provider |
208541184 |
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 |
44 |
Number Of Services |
877 |
Number Of Medicare Beneficiaries |
541 |
Total Submitted Charge Amount |
427337.82 |
Total Medicare Allowed Amount |
99723.42 |
Total Medicare Payment Amount |
76612.05 |
Total Medicare Standardized Payment Amount |
78136.99 |
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 |
44 |
Number Of Medical Services |
877 |
Number Of Medicare Beneficiaries With Medical Services |
541 |
Total Medical Submitted Charge Amount |
427337.82 |
Total Medical Medicare Allowed Amount |
99723.42 |
Total Medical Medicare Payment Amount |
76612.05 |
Total Medical Medicare Standardized Payment Amount |
78136.99 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
167 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
291 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
511 |
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 |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
261 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9373 |