National Provider Identifier [NPI]: |
1073596912 |
Last Name Of The Provider |
LU |
First Name Of The Provider |
HERMAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25405 HANCOCK AVE |
Street Address 2 Of The Provider |
SUITE 216 |
City Of The Provider |
MURRIETA |
Zip Code Of The Provider |
925625982 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
5025 |
Number Of Medicare Beneficiaries |
522 |
Total Submitted Charge Amount |
1525725 |
Total Medicare Allowed Amount |
600480.69 |
Total Medicare Payment Amount |
458365.07 |
Total Medicare Standardized Payment Amount |
443006.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
951 |
Number Of Medicare Beneficiaries With Drug Services |
199 |
Total Drug Submitted ChargeAmount |
99530 |
Total Drug Medicare AllowedAmount |
39694.78 |
Total Drug Medicare PaymentAmount |
30755.92 |
Total Drug Medicare Standardized Payment Amount |
30755.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
4074 |
Number Of Medicare Beneficiaries With Medical Services |
522 |
Total Medical Submitted Charge Amount |
1426195 |
Total Medical Medicare Allowed Amount |
560785.91 |
Total Medical Medicare Payment Amount |
427609.15 |
Total Medical Medicare Standardized Payment Amount |
412250.43 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
204 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
290 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
418 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
447 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.3274 |