National Provider Identifier [NPI]: |
1306817184 |
Last Name Of The Provider |
DOSUNMU-OGUNBI |
First Name Of The Provider |
ADEDOYIN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1722 PINE ST |
Street Address 2 Of The Provider |
SUITE 1005 |
City Of The Provider |
MONTGOMERY |
Zip Code Of The Provider |
361061103 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2563 |
Number Of Medicare Beneficiaries |
666 |
Total Submitted Charge Amount |
238915 |
Total Medicare Allowed Amount |
155692.1 |
Total Medicare Payment Amount |
116551.74 |
Total Medicare Standardized Payment Amount |
125626.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
222 |
Number Of Medicare Beneficiaries With Drug Services |
146 |
Total Drug Submitted ChargeAmount |
6417 |
Total Drug Medicare AllowedAmount |
3273.2 |
Total Drug Medicare PaymentAmount |
3056.35 |
Total Drug Medicare Standardized Payment Amount |
3056.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
2341 |
Number Of Medicare Beneficiaries With Medical Services |
666 |
Total Medical Submitted Charge Amount |
232498 |
Total Medical Medicare Allowed Amount |
152418.9 |
Total Medical Medicare Payment Amount |
113495.39 |
Total Medical Medicare Standardized Payment Amount |
122569.81 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
213 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
391 |
Number Of Male Beneficiaries |
275 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
378 |
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 |
465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
201 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.9874 |