| National Provider Identifier [NPI]: | 1215164769 |
| Last Name Of The Provider | KUSEMIJU |
| First Name Of The Provider | OLADIPO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 146 HIGHLAND PKWY |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | PICAYUNE |
| Zip Code Of The Provider | 394665575 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 1090 |
| Number Of Medicare Beneficiaries | 293 |
| Total Submitted Charge Amount | 118218.79 |
| Total Medicare Allowed Amount | 92701.2 |
| Total Medicare Payment Amount | 65748.73 |
| Total Medicare Standardized Payment Amount | 71645.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 957 |
| Total Drug Medicare AllowedAmount | 505.14 |
| Total Drug Medicare PaymentAmount | 486.23 |
| Total Drug Medicare Standardized Payment Amount | 486.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1055 |
| Number Of Medicare Beneficiaries With Medical Services | 293 |
| Total Medical Submitted Charge Amount | 117261.79 |
| Total Medical Medicare Allowed Amount | 92196.06 |
| Total Medical Medicare Payment Amount | 65262.5 |
| Total Medical Medicare Standardized Payment Amount | 71159.71 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 229 |
| 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 | 134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3226 |