| National Provider Identifier [NPI]: | 1124093471 |
| Last Name Of The Provider | PHILIP |
| First Name Of The Provider | MOHAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4221 RIDGECREST RD |
| Street Address 2 Of The Provider | STE 107 |
| City Of The Provider | GREENVILLE |
| Zip Code Of The Provider | 754026015 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 4710 |
| Number Of Medicare Beneficiaries | 1020 |
| Total Submitted Charge Amount | 651155.48 |
| Total Medicare Allowed Amount | 394004.92 |
| Total Medicare Payment Amount | 302080.47 |
| Total Medicare Standardized Payment Amount | 317402.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 707 |
| Number Of Medicare Beneficiaries With Drug Services | 221 |
| Total Drug Submitted ChargeAmount | 3535 |
| Total Drug Medicare AllowedAmount | 36.93 |
| Total Drug Medicare PaymentAmount | 29.6 |
| Total Drug Medicare Standardized Payment Amount | 29.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 4003 |
| Number Of Medicare Beneficiaries With Medical Services | 1020 |
| Total Medical Submitted Charge Amount | 647620.48 |
| Total Medical Medicare Allowed Amount | 393967.99 |
| Total Medical Medicare Payment Amount | 302050.87 |
| Total Medical Medicare Standardized Payment Amount | 317372.66 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 427 |
| Number Of Beneficiaries Age 75 to 84 | 309 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 542 |
| Number Of Male Beneficiaries | 478 |
| Number Of Non Hispanic White Beneficiaries | 920 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 729 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 291 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7941 |