National Provider Identifier [NPI]: |
1629017140 |
Last Name Of The Provider |
CHIN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3200 KEARNEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FREMONT |
Zip Code Of The Provider |
945382299 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
113 |
Number Of Services |
16823 |
Number Of Medicare Beneficiaries |
1662 |
Total Submitted Charge Amount |
1273754.75 |
Total Medicare Allowed Amount |
293742.92 |
Total Medicare Payment Amount |
219565.8 |
Total Medicare Standardized Payment Amount |
177117.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
14722 |
Number Of Medicare Beneficiaries With Drug Services |
140 |
Total Drug Submitted ChargeAmount |
16610 |
Total Drug Medicare AllowedAmount |
3646.31 |
Total Drug Medicare PaymentAmount |
2849.6 |
Total Drug Medicare Standardized Payment Amount |
2849.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
110 |
Number Of Medical Services |
2101 |
Number Of Medicare Beneficiaries With Medical Services |
1662 |
Total Medical Submitted Charge Amount |
1257144.75 |
Total Medical Medicare Allowed Amount |
290096.61 |
Total Medical Medicare Payment Amount |
216716.2 |
Total Medical Medicare Standardized Payment Amount |
174267.79 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
804 |
Number Of Beneficiaries Age 75 to 84 |
513 |
Number Of Beneficiaries Age Greater 84 |
220 |
Number Of Female Beneficiaries |
1025 |
Number Of Male Beneficiaries |
637 |
Number Of Non Hispanic White Beneficiaries |
1067 |
Number Of Black or African American Beneficiaries |
62 |
Number Of AsianPacific Islander Beneficiaries |
324 |
Number Of Hispanic Beneficiaries |
157 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
318 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0669 |