| National Provider Identifier [NPI]: | 1063709749 |
| Last Name Of The Provider | KOKANOVIC |
| First Name Of The Provider | SIMONIDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21425 SPRING ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | UNION GROVE |
| Zip Code Of The Provider | 531829707 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 569 |
| Number Of Medicare Beneficiaries | 99 |
| Total Submitted Charge Amount | 26068.28 |
| Total Medicare Allowed Amount | 26002.5 |
| Total Medicare Payment Amount | 19957.79 |
| Total Medicare Standardized Payment Amount | 26379.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 774.18 |
| Total Drug Medicare AllowedAmount | 708.4 |
| Total Drug Medicare PaymentAmount | 694.14 |
| Total Drug Medicare Standardized Payment Amount | 694.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 523 |
| Number Of Medicare Beneficiaries With Medical Services | 99 |
| Total Medical Submitted Charge Amount | 25294.1 |
| Total Medical Medicare Allowed Amount | 25294.1 |
| Total Medical Medicare Payment Amount | 19263.65 |
| Total Medical Medicare Standardized Payment Amount | 25684.9 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 29 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | 88 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 0 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 23 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 37 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 13 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.605 |