National Provider Identifier [NPI]: |
1710976618 |
Last Name Of The Provider |
SUNG |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2015 N MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WHEATON |
Zip Code Of The Provider |
601873152 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
5034 |
Number Of Medicare Beneficiaries |
1299 |
Total Submitted Charge Amount |
620388.27 |
Total Medicare Allowed Amount |
586774.08 |
Total Medicare Payment Amount |
416664.17 |
Total Medicare Standardized Payment Amount |
392427.01 |
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 |
40 |
Number Of Medical Services |
5034 |
Number Of Medicare Beneficiaries With Medical Services |
1299 |
Total Medical Submitted Charge Amount |
620388.27 |
Total Medical Medicare Allowed Amount |
586774.08 |
Total Medical Medicare Payment Amount |
416664.17 |
Total Medical Medicare Standardized Payment Amount |
392427.01 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
421 |
Number Of Beneficiaries Age 75 to 84 |
506 |
Number Of Beneficiaries Age Greater 84 |
311 |
Number Of Female Beneficiaries |
800 |
Number Of Male Beneficiaries |
499 |
Number Of Non Hispanic White Beneficiaries |
1130 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
55 |
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0778 |