National Provider Identifier [NPI]: |
1356771729 |
Last Name Of The Provider |
OGUNNIYI |
First Name Of The Provider |
RUTH |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
ANP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1027 BELLEVUE AVE |
Street Address 2 Of The Provider |
STE 107 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631171851 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
83 |
Number Of Medicare Beneficiaries |
48 |
Total Submitted Charge Amount |
22088.37 |
Total Medicare Allowed Amount |
6135.93 |
Total Medicare Payment Amount |
4777.22 |
Total Medicare Standardized Payment Amount |
5703.68 |
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 |
10 |
Number Of Medical Services |
83 |
Number Of Medicare Beneficiaries With Medical Services |
48 |
Total Medical Submitted Charge Amount |
22088.37 |
Total Medical Medicare Allowed Amount |
6135.93 |
Total Medical Medicare Payment Amount |
4777.22 |
Total Medical Medicare Standardized Payment Amount |
5703.68 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
19 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
28 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
46 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4712 |