National Provider Identifier [NPI]: |
1407022957 |
Last Name Of The Provider |
MOLOKWU |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9849 KENWORTHY ST |
Street Address 2 Of The Provider |
TTUHSC FAMILY MEDICAL CENTER |
City Of The Provider |
EL PASO |
Zip Code Of The Provider |
799244402 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
751 |
Number Of Medicare Beneficiaries |
323 |
Total Submitted Charge Amount |
90183.88 |
Total Medicare Allowed Amount |
54057.26 |
Total Medicare Payment Amount |
37948.54 |
Total Medicare Standardized Payment Amount |
39897.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
2964.88 |
Total Drug Medicare AllowedAmount |
1900.78 |
Total Drug Medicare PaymentAmount |
1862.55 |
Total Drug Medicare Standardized Payment Amount |
1862.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
708 |
Number Of Medicare Beneficiaries With Medical Services |
323 |
Total Medical Submitted Charge Amount |
87219 |
Total Medical Medicare Allowed Amount |
52156.48 |
Total Medical Medicare Payment Amount |
36085.99 |
Total Medical Medicare Standardized Payment Amount |
38034.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
174 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3697 |