National Provider Identifier [NPI]: |
1003015462 |
Last Name Of The Provider |
CHANG |
First Name Of The Provider |
CHUN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 PARADISE RD |
Street Address 2 Of The Provider |
#E |
City Of The Provider |
MODESTO |
Zip Code Of The Provider |
953513163 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
537 |
Number Of Medicare Beneficiaries |
330 |
Total Submitted Charge Amount |
290185 |
Total Medicare Allowed Amount |
67406.65 |
Total Medicare Payment Amount |
52845.01 |
Total Medicare Standardized Payment Amount |
52212.88 |
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 |
19 |
Number Of Medical Services |
537 |
Number Of Medicare Beneficiaries With Medical Services |
330 |
Total Medical Submitted Charge Amount |
290185 |
Total Medical Medicare Allowed Amount |
67406.65 |
Total Medical Medicare Payment Amount |
52845.01 |
Total Medical Medicare Standardized Payment Amount |
52212.88 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
180 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
98 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
52 |
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 |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2945 |