National Provider Identifier [NPI]: |
1174501233 |
Last Name Of The Provider |
ODUNSI |
First Name Of The Provider |
ADEDAYO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 ELIZABETH PL |
Street Address 2 Of The Provider |
SUITE 190 |
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454173445 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
28114 |
Number Of Medicare Beneficiaries |
637 |
Total Submitted Charge Amount |
4232922.6 |
Total Medicare Allowed Amount |
1180051.02 |
Total Medicare Payment Amount |
901600.8 |
Total Medicare Standardized Payment Amount |
995032.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
25063 |
Number Of Medicare Beneficiaries With Drug Services |
342 |
Total Drug Submitted ChargeAmount |
60951.6 |
Total Drug Medicare AllowedAmount |
5226.37 |
Total Drug Medicare PaymentAmount |
3997.76 |
Total Drug Medicare Standardized Payment Amount |
3997.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
3051 |
Number Of Medicare Beneficiaries With Medical Services |
637 |
Total Medical Submitted Charge Amount |
4171971 |
Total Medical Medicare Allowed Amount |
1174824.65 |
Total Medical Medicare Payment Amount |
897603.04 |
Total Medical Medicare Standardized Payment Amount |
991034.81 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
299 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
270 |
Number Of Male Beneficiaries |
367 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
255 |
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 |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
342 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
72 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
73 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
7.4206 |