| National Provider Identifier [NPI]: | 1831175421 |
| Last Name Of The Provider | KOK |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7430 WILLOW LEAF CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240185921 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 4736 |
| Number Of Medicare Beneficiaries | 3321 |
| Total Submitted Charge Amount | 433946 |
| Total Medicare Allowed Amount | 165847.13 |
| Total Medicare Payment Amount | 124047.05 |
| Total Medicare Standardized Payment Amount | 129063.74 |
| 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 | 159 |
| Number Of Medical Services | 4736 |
| Number Of Medicare Beneficiaries With Medical Services | 3321 |
| Total Medical Submitted Charge Amount | 433946 |
| Total Medical Medicare Allowed Amount | 165847.13 |
| Total Medical Medicare Payment Amount | 124047.05 |
| Total Medical Medicare Standardized Payment Amount | 129063.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 746 |
| Number Of Beneficiaries Age 65 to 74 | 1241 |
| Number Of Beneficiaries Age 75 to 84 | 881 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 1923 |
| Number Of Male Beneficiaries | 1398 |
| Number Of Non Hispanic White Beneficiaries | 2942 |
| Number Of Black or African American Beneficiaries | 324 |
| 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 | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2466 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 855 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6316 |