National Provider Identifier [NPI]: |
1346389335 |
Last Name Of The Provider |
MOKWE |
First Name Of The Provider |
EVAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
311 CAMDEN ST |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782152012 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
4512 |
Number Of Medicare Beneficiaries |
1650 |
Total Submitted Charge Amount |
585440.72 |
Total Medicare Allowed Amount |
295270.38 |
Total Medicare Payment Amount |
223130.93 |
Total Medicare Standardized Payment Amount |
236948.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
72 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
3942.72 |
Total Drug Medicare AllowedAmount |
3812.51 |
Total Drug Medicare PaymentAmount |
2982.32 |
Total Drug Medicare Standardized Payment Amount |
2982.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
4440 |
Number Of Medicare Beneficiaries With Medical Services |
1650 |
Total Medical Submitted Charge Amount |
581498 |
Total Medical Medicare Allowed Amount |
291457.87 |
Total Medical Medicare Payment Amount |
220148.61 |
Total Medical Medicare Standardized Payment Amount |
233966.24 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
440 |
Number Of Beneficiaries Age 65 to 74 |
514 |
Number Of Beneficiaries Age 75 to 84 |
451 |
Number Of Beneficiaries Age Greater 84 |
245 |
Number Of Female Beneficiaries |
926 |
Number Of Male Beneficiaries |
724 |
Number Of Non Hispanic White Beneficiaries |
544 |
Number Of Black or African American Beneficiaries |
217 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
875 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
834 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
816 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8079 |