| National Provider Identifier [NPI]: | 1104862531 |
| Last Name Of The Provider | IFEDIBA |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1515 6TH AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352331601 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 27760.5 |
| Number Of Medicare Beneficiaries | 224 |
| Total Submitted Charge Amount | 600313.6 |
| Total Medicare Allowed Amount | 418979.37 |
| Total Medicare Payment Amount | 320261.82 |
| Total Medicare Standardized Payment Amount | 329924.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1218.5 |
| Number Of Medicare Beneficiaries With Drug Services | 116 |
| Total Drug Submitted ChargeAmount | 13959.5 |
| Total Drug Medicare AllowedAmount | 796.2 |
| Total Drug Medicare PaymentAmount | 660.88 |
| Total Drug Medicare Standardized Payment Amount | 660.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 26542 |
| Number Of Medicare Beneficiaries With Medical Services | 224 |
| Total Medical Submitted Charge Amount | 586354.1 |
| Total Medical Medicare Allowed Amount | 418183.17 |
| Total Medical Medicare Payment Amount | 319600.94 |
| Total Medical Medicare Standardized Payment Amount | 329263.59 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 193 |
| 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 | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5034 |