National Provider Identifier [NPI]: |
1841269164 |
Last Name Of The Provider |
MOHAN |
First Name Of The Provider |
KOCHUNNI |
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 |
714 S TRUMBULL ST |
Street Address 2 Of The Provider |
STE 2 |
City Of The Provider |
BAY CITY |
Zip Code Of The Provider |
487084217 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
8447 |
Number Of Medicare Beneficiaries |
1450 |
Total Submitted Charge Amount |
1285526 |
Total Medicare Allowed Amount |
774896.58 |
Total Medicare Payment Amount |
584560.39 |
Total Medicare Standardized Payment Amount |
604009.92 |
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 |
75 |
Number Of Medical Services |
8447 |
Number Of Medicare Beneficiaries With Medical Services |
1450 |
Total Medical Submitted Charge Amount |
1285526 |
Total Medical Medicare Allowed Amount |
774896.58 |
Total Medical Medicare Payment Amount |
584560.39 |
Total Medical Medicare Standardized Payment Amount |
604009.92 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
476 |
Number Of Beneficiaries Age 75 to 84 |
496 |
Number Of Beneficiaries Age Greater 84 |
295 |
Number Of Female Beneficiaries |
725 |
Number Of Male Beneficiaries |
725 |
Number Of Non Hispanic White Beneficiaries |
1371 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
1185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
265 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6451 |