National Provider Identifier [NPI]: |
1184737397 |
Last Name Of The Provider |
DAWODU |
First Name Of The Provider |
OLUDAYO |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4212 CARMICHAEL CT N |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTGOMERY |
Zip Code Of The Provider |
361063621 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
4291 |
Number Of Medicare Beneficiaries |
775 |
Total Submitted Charge Amount |
283003.5 |
Total Medicare Allowed Amount |
220126.23 |
Total Medicare Payment Amount |
161844.19 |
Total Medicare Standardized Payment Amount |
175967.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
957 |
Number Of Medicare Beneficiaries With Drug Services |
213 |
Total Drug Submitted ChargeAmount |
15550 |
Total Drug Medicare AllowedAmount |
2338.12 |
Total Drug Medicare PaymentAmount |
1773.8 |
Total Drug Medicare Standardized Payment Amount |
1773.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
3334 |
Number Of Medicare Beneficiaries With Medical Services |
775 |
Total Medical Submitted Charge Amount |
267453.5 |
Total Medical Medicare Allowed Amount |
217788.11 |
Total Medical Medicare Payment Amount |
160070.39 |
Total Medical Medicare Standardized Payment Amount |
174193.44 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
218 |
Number Of Beneficiaries Age Greater 84 |
134 |
Number Of Female Beneficiaries |
456 |
Number Of Male Beneficiaries |
319 |
Number Of Non Hispanic White Beneficiaries |
372 |
Number Of Black or African American Beneficiaries |
388 |
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 |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
444 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
47 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9497 |