| National Provider Identifier [NPI]: | 1205000296 |
| Last Name Of The Provider | OKEWOLE |
| First Name Of The Provider | SIMON |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17 CENTRE PLAZA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383052862 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 10620 |
| Number Of Medicare Beneficiaries | 1332 |
| Total Submitted Charge Amount | 1290223.15 |
| Total Medicare Allowed Amount | 470537.7 |
| Total Medicare Payment Amount | 359403.94 |
| Total Medicare Standardized Payment Amount | 388684.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 6600 |
| Number Of Medicare Beneficiaries With Drug Services | 242 |
| Total Drug Submitted ChargeAmount | 24467.8 |
| Total Drug Medicare AllowedAmount | 17192.3 |
| Total Drug Medicare PaymentAmount | 13143.97 |
| Total Drug Medicare Standardized Payment Amount | 13143.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 4020 |
| Number Of Medicare Beneficiaries With Medical Services | 1332 |
| Total Medical Submitted Charge Amount | 1265755.35 |
| Total Medical Medicare Allowed Amount | 453345.4 |
| Total Medical Medicare Payment Amount | 346259.97 |
| Total Medical Medicare Standardized Payment Amount | 375540.26 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 335 |
| Number Of Beneficiaries Age 65 to 74 | 528 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 674 |
| Number Of Male Beneficiaries | 658 |
| Number Of Non Hispanic White Beneficiaries | 1126 |
| Number Of Black or African American Beneficiaries | 190 |
| 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 | 732 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 600 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0692 |