| National Provider Identifier [NPI]: | 1083615348 |
| Last Name Of The Provider | MOGBO |
| First Name Of The Provider | SOLOMON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 S UNIVERSITY AVE |
| Street Address 2 Of The Provider | SUITE 605 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722055302 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 9625 |
| Number Of Medicare Beneficiaries | 836 |
| Total Submitted Charge Amount | 1402409 |
| Total Medicare Allowed Amount | 754813.06 |
| Total Medicare Payment Amount | 584363.67 |
| Total Medicare Standardized Payment Amount | 612086.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 3800 |
| Total Drug Medicare AllowedAmount | 1539.54 |
| Total Drug Medicare PaymentAmount | 1493.52 |
| Total Drug Medicare Standardized Payment Amount | 1493.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 9557 |
| Number Of Medicare Beneficiaries With Medical Services | 836 |
| Total Medical Submitted Charge Amount | 1398609 |
| Total Medical Medicare Allowed Amount | 753273.52 |
| Total Medical Medicare Payment Amount | 582870.15 |
| Total Medical Medicare Standardized Payment Amount | 610592.9 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 246 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 463 |
| Number Of Male Beneficiaries | 373 |
| Number Of Non Hispanic White Beneficiaries | 480 |
| Number Of Black or African American Beneficiaries | 339 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 460 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.2325 |