National Provider Identifier [NPI]: |
1154399061 |
Last Name Of The Provider |
YUN |
First Name Of The Provider |
BOBBY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1855 S KOELLER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OSHKOSH |
Zip Code Of The Provider |
549026214 |
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 |
38 |
Number Of Services |
359 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
65934.97 |
Total Medicare Allowed Amount |
27913.2 |
Total Medicare Payment Amount |
17188.78 |
Total Medicare Standardized Payment Amount |
18310.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
623.33 |
Total Drug Medicare AllowedAmount |
108.53 |
Total Drug Medicare PaymentAmount |
98.71 |
Total Drug Medicare Standardized Payment Amount |
98.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
321 |
Number Of Medicare Beneficiaries With Medical Services |
234 |
Total Medical Submitted Charge Amount |
65311.64 |
Total Medical Medicare Allowed Amount |
27804.67 |
Total Medical Medicare Payment Amount |
17090.07 |
Total Medical Medicare Standardized Payment Amount |
18212.1 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
139 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
164 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0688 |