National Provider Identifier [NPI]: |
1912293077 |
Last Name Of The Provider |
OLUWABUSI |
First Name Of The Provider |
TITILAYO |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 E APPLE ST |
Street Address 2 Of The Provider |
SUITE 3300 |
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454092939 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
775 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
105138 |
Total Medicare Allowed Amount |
73163.17 |
Total Medicare Payment Amount |
55765.51 |
Total Medicare Standardized Payment Amount |
57706.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
775 |
Number Of Medicare Beneficiaries With Medical Services |
325 |
Total Medical Submitted Charge Amount |
105138 |
Total Medical Medicare Allowed Amount |
73163.17 |
Total Medical Medicare Payment Amount |
55765.51 |
Total Medical Medicare Standardized Payment Amount |
57706.77 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
263 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4028 |