National Provider Identifier [NPI]: |
1750341293 |
Last Name Of The Provider |
BAMIRO |
First Name Of The Provider |
OLUJIDE |
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 |
1761 BEALL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WOOSTER |
Zip Code Of The Provider |
446912342 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
2159 |
Number Of Medicare Beneficiaries |
503 |
Total Submitted Charge Amount |
631597 |
Total Medicare Allowed Amount |
220393.49 |
Total Medicare Payment Amount |
172295.59 |
Total Medicare Standardized Payment Amount |
178229.2 |
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 |
16 |
Number Of Medical Services |
2159 |
Number Of Medicare Beneficiaries With Medical Services |
503 |
Total Medical Submitted Charge Amount |
631597 |
Total Medical Medicare Allowed Amount |
220393.49 |
Total Medical Medicare Payment Amount |
172295.59 |
Total Medical Medicare Standardized Payment Amount |
178229.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
154 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
295 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
432 |
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 |
294 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
209 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.8198 |