| National Provider Identifier [NPI]: | 1205869815 |
| Last Name Of The Provider | OBASI |
| First Name Of The Provider | EJIKEME |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9125 S PULASKI RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EVERGREEN PARK |
| Zip Code Of The Provider | 608051441 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 4102 |
| Number Of Medicare Beneficiaries | 717 |
| Total Submitted Charge Amount | 1233116.1 |
| Total Medicare Allowed Amount | 412104.61 |
| Total Medicare Payment Amount | 313996.91 |
| Total Medicare Standardized Payment Amount | 297582.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 458 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 4660 |
| Total Drug Medicare AllowedAmount | 1797.22 |
| Total Drug Medicare PaymentAmount | 1361.11 |
| Total Drug Medicare Standardized Payment Amount | 1361.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 3644 |
| Number Of Medicare Beneficiaries With Medical Services | 717 |
| Total Medical Submitted Charge Amount | 1228456.1 |
| Total Medical Medicare Allowed Amount | 410307.39 |
| Total Medical Medicare Payment Amount | 312635.8 |
| Total Medical Medicare Standardized Payment Amount | 296221.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 346 |
| Number Of Non Hispanic White Beneficiaries | 282 |
| Number Of Black or African American Beneficiaries | 382 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 497 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 220 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 66 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 4.0501 |