| National Provider Identifier [NPI]: | 1659577484 |
| Last Name Of The Provider | EKPENIKE |
| First Name Of The Provider | ANTHONIA |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.B.B.S |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 UPPER RIVERDALE RD SW |
| Street Address 2 Of The Provider | SOUTHERN REGIONAL MEDICAL CENTER |
| City Of The Provider | RIVERDALE |
| Zip Code Of The Provider | 302742615 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 1059 |
| Number Of Medicare Beneficiaries | 361 |
| Total Submitted Charge Amount | 216365 |
| Total Medicare Allowed Amount | 99046.1 |
| Total Medicare Payment Amount | 76791.4 |
| Total Medicare Standardized Payment Amount | 77429.93 |
| 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 | 12 |
| Number Of Medical Services | 1059 |
| Number Of Medicare Beneficiaries With Medical Services | 361 |
| Total Medical Submitted Charge Amount | 216365 |
| Total Medical Medicare Allowed Amount | 99046.1 |
| Total Medical Medicare Payment Amount | 76791.4 |
| Total Medical Medicare Standardized Payment Amount | 77429.93 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 170 |
| Number Of Non Hispanic White Beneficiaries | 121 |
| Number Of Black or African American Beneficiaries | 220 |
| 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 | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 68 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 3.3648 |