National Provider Identifier [NPI]: |
1407848104 |
Last Name Of The Provider |
OMITOWOJU |
First Name Of The Provider |
OLADAPO |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1801 N WASHINGTON ST |
Street Address 2 Of The Provider |
STE. 300 |
City Of The Provider |
TULLAHOMA |
Zip Code Of The Provider |
373888245 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
4690 |
Number Of Medicare Beneficiaries |
868 |
Total Submitted Charge Amount |
1463510.5 |
Total Medicare Allowed Amount |
460997.06 |
Total Medicare Payment Amount |
354082.95 |
Total Medicare Standardized Payment Amount |
374546.1 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
182 |
Number Of Beneficiaries Age 65 to 74 |
259 |
Number Of Beneficiaries Age 75 to 84 |
298 |
Number Of Beneficiaries Age Greater 84 |
129 |
Number Of Female Beneficiaries |
454 |
Number Of Male Beneficiaries |
414 |
Number Of Non Hispanic White Beneficiaries |
766 |
Number Of Black or African American Beneficiaries |
87 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
592 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
276 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
3.2903 |