| National Provider Identifier [NPI]: | 1275548729 |
| Last Name Of The Provider | EBO |
| First Name Of The Provider | CHUKWUMA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1124 MACE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212213315 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2418 |
| Number Of Medicare Beneficiaries | 321 |
| Total Submitted Charge Amount | 270890 |
| Total Medicare Allowed Amount | 204983.34 |
| Total Medicare Payment Amount | 151839.84 |
| Total Medicare Standardized Payment Amount | 143016.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 113 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 4435 |
| Total Drug Medicare AllowedAmount | 2489.05 |
| Total Drug Medicare PaymentAmount | 2435.81 |
| Total Drug Medicare Standardized Payment Amount | 2435.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2305 |
| Number Of Medicare Beneficiaries With Medical Services | 321 |
| Total Medical Submitted Charge Amount | 266455 |
| Total Medical Medicare Allowed Amount | 202494.29 |
| Total Medical Medicare Payment Amount | 149404.03 |
| Total Medical Medicare Standardized Payment Amount | 140581.08 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 121 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | 295 |
| 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 | 254 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7331 |