National Provider Identifier [NPI]: |
1881653715 |
Last Name Of The Provider |
OFODILE |
First Name Of The Provider |
IJE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3720 DAVINCI CT STE 400 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORCROSS |
Zip Code Of The Provider |
300927625 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
635 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
69785 |
Total Medicare Allowed Amount |
47973.37 |
Total Medicare Payment Amount |
37610.54 |
Total Medicare Standardized Payment Amount |
44297.05 |
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 |
4 |
Number Of Medical Services |
635 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
69785 |
Total Medical Medicare Allowed Amount |
47973.37 |
Total Medical Medicare Payment Amount |
37610.54 |
Total Medical Medicare Standardized Payment Amount |
44297.05 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
90 |
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 |
27 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
60 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
37 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
2.468 |