| National Provider Identifier [NPI]: | 1356308381 |
| Last Name Of The Provider | OLATUNJI |
| First Name Of The Provider | ADEBOLA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 650 SAINT LOUIS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761043346 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 6424 |
| Number Of Medicare Beneficiaries | 690 |
| Total Submitted Charge Amount | 727015.91 |
| Total Medicare Allowed Amount | 521343.98 |
| Total Medicare Payment Amount | 400649.51 |
| Total Medicare Standardized Payment Amount | 405790.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 480 |
| Total Drug Medicare AllowedAmount | 449.5 |
| Total Drug Medicare PaymentAmount | 440.57 |
| Total Drug Medicare Standardized Payment Amount | 440.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 6392 |
| Number Of Medicare Beneficiaries With Medical Services | 690 |
| Total Medical Submitted Charge Amount | 726535.91 |
| Total Medical Medicare Allowed Amount | 520894.48 |
| Total Medical Medicare Payment Amount | 400208.94 |
| Total Medical Medicare Standardized Payment Amount | 405350.18 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 386 |
| Number Of Male Beneficiaries | 304 |
| Number Of Non Hispanic White Beneficiaries | 420 |
| Number Of Black or African American Beneficiaries | 172 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 87 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 463 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 54 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 68 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 40 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.9064 |