National Provider Identifier [NPI]: |
1134172281 |
Last Name Of The Provider |
KOHAN |
First Name Of The Provider |
WAYNE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
320 W 10TH AVE |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
KENNEWICK |
Zip Code Of The Provider |
993366302 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1287 |
Number Of Medicare Beneficiaries |
522 |
Total Submitted Charge Amount |
146522 |
Total Medicare Allowed Amount |
97831.52 |
Total Medicare Payment Amount |
67620.78 |
Total Medicare Standardized Payment Amount |
68813.24 |
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 |
52 |
Number Of Medical Services |
1287 |
Number Of Medicare Beneficiaries With Medical Services |
522 |
Total Medical Submitted Charge Amount |
146522 |
Total Medical Medicare Allowed Amount |
97831.52 |
Total Medical Medicare Payment Amount |
67620.78 |
Total Medical Medicare Standardized Payment Amount |
68813.24 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
307 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
492 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
464 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3575 |