National Provider Identifier [NPI]: |
1447336623 |
Last Name Of The Provider |
KOYA |
First Name Of The Provider |
IBIKUNLE |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1205 YORK RD |
Street Address 2 Of The Provider |
SUITE 26 |
City Of The Provider |
LUTHERVILLE |
Zip Code Of The Provider |
210936210 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
3866 |
Number Of Medicare Beneficiaries |
790 |
Total Submitted Charge Amount |
1000034.89 |
Total Medicare Allowed Amount |
399704.57 |
Total Medicare Payment Amount |
305668.38 |
Total Medicare Standardized Payment Amount |
291814.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
774 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
22194.41 |
Total Drug Medicare AllowedAmount |
8865.94 |
Total Drug Medicare PaymentAmount |
6587.4 |
Total Drug Medicare Standardized Payment Amount |
6587.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
3092 |
Number Of Medicare Beneficiaries With Medical Services |
790 |
Total Medical Submitted Charge Amount |
977840.48 |
Total Medical Medicare Allowed Amount |
390838.63 |
Total Medical Medicare Payment Amount |
299080.98 |
Total Medical Medicare Standardized Payment Amount |
285226.63 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
187 |
Number Of Beneficiaries Age 65 to 74 |
257 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
384 |
Number Of Male Beneficiaries |
406 |
Number Of Non Hispanic White Beneficiaries |
364 |
Number Of Black or African American Beneficiaries |
406 |
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 |
580 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
210 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
5.0779 |