National Provider Identifier [NPI]: |
1336123819 |
Last Name Of The Provider |
LUM |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7117 BROCKTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIVERSIDE |
Zip Code Of The Provider |
925062615 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
520 |
Number Of Medicare Beneficiaries |
209 |
Total Submitted Charge Amount |
81822 |
Total Medicare Allowed Amount |
49340.96 |
Total Medicare Payment Amount |
32949.13 |
Total Medicare Standardized Payment Amount |
32090.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
2563 |
Total Drug Medicare AllowedAmount |
1074.39 |
Total Drug Medicare PaymentAmount |
1038.76 |
Total Drug Medicare Standardized Payment Amount |
1038.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
500 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
79259 |
Total Medical Medicare Allowed Amount |
48266.57 |
Total Medical Medicare Payment Amount |
31910.37 |
Total Medical Medicare Standardized Payment Amount |
31051.8 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
154 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.4017 |