National Provider Identifier [NPI]: |
1205844974 |
Last Name Of The Provider |
IKEDIONWU |
First Name Of The Provider |
FREEDOM |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
145 W 4TH ST |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
COOKEVILLE |
Zip Code Of The Provider |
385012447 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
940 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
252778 |
Total Medicare Allowed Amount |
104213.66 |
Total Medicare Payment Amount |
77736.86 |
Total Medicare Standardized Payment Amount |
84818.26 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
217 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
72 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
3.2427 |