| National Provider Identifier [NPI]: | 1295947083 |
| Last Name Of The Provider | MONGWA |
| First Name Of The Provider | MBU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 W PARK ST |
| Street Address 2 Of The Provider | CARDIOLOGY |
| City Of The Provider | URBANA |
| Zip Code Of The Provider | 618012529 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 2608 |
| Number Of Medicare Beneficiaries | 1611 |
| Total Submitted Charge Amount | 1213985 |
| Total Medicare Allowed Amount | 189906.02 |
| Total Medicare Payment Amount | 141321.69 |
| Total Medicare Standardized Payment Amount | 145416.27 |
| 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 | 63 |
| Number Of Medical Services | 2608 |
| Number Of Medicare Beneficiaries With Medical Services | 1611 |
| Total Medical Submitted Charge Amount | 1213985 |
| Total Medical Medicare Allowed Amount | 189906.02 |
| Total Medical Medicare Payment Amount | 141321.69 |
| Total Medical Medicare Standardized Payment Amount | 145416.27 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 490 |
| Number Of Beneficiaries Age 75 to 84 | 522 |
| Number Of Beneficiaries Age Greater 84 | 340 |
| Number Of Female Beneficiaries | 789 |
| Number Of Male Beneficiaries | 822 |
| Number Of Non Hispanic White Beneficiaries | 1446 |
| Number Of Black or African American Beneficiaries | 124 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.772 |