National Provider Identifier [NPI]: |
1619942661 |
Last Name Of The Provider |
TONG |
First Name Of The Provider |
ARTHUR |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MBBS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
40 SECOND AVE |
Street Address 2 Of The Provider |
MASS GENERAL WEST |
City Of The Provider |
WALTHAM |
Zip Code Of The Provider |
02451 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
2583 |
Number Of Medicare Beneficiaries |
785 |
Total Submitted Charge Amount |
612808 |
Total Medicare Allowed Amount |
176794.76 |
Total Medicare Payment Amount |
124516.62 |
Total Medicare Standardized Payment Amount |
114107.82 |
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 |
42 |
Number Of Medical Services |
2583 |
Number Of Medicare Beneficiaries With Medical Services |
785 |
Total Medical Submitted Charge Amount |
612808 |
Total Medical Medicare Allowed Amount |
176794.76 |
Total Medical Medicare Payment Amount |
124516.62 |
Total Medical Medicare Standardized Payment Amount |
114107.82 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
365 |
Number Of Beneficiaries Age 75 to 84 |
253 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
365 |
Number Of Male Beneficiaries |
420 |
Number Of Non Hispanic White Beneficiaries |
746 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
740 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9671 |