National Provider Identifier [NPI]: |
1710933270 |
Last Name Of The Provider |
NUNYAKPE |
First Name Of The Provider |
ABALO |
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 |
7810 WEST GOOD HOPE ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
53223 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
2938 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
589495 |
Total Medicare Allowed Amount |
212861.26 |
Total Medicare Payment Amount |
154781.73 |
Total Medicare Standardized Payment Amount |
164275.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
2682 |
Total Drug Medicare AllowedAmount |
316.7 |
Total Drug Medicare PaymentAmount |
298.9 |
Total Drug Medicare Standardized Payment Amount |
298.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
2888 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
586813 |
Total Medical Medicare Allowed Amount |
212544.56 |
Total Medical Medicare Payment Amount |
154482.83 |
Total Medical Medicare Standardized Payment Amount |
163976.87 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
270 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
240 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
71 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
3 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3117 |