| National Provider Identifier [NPI]: | 1659376606 |
| Last Name Of The Provider | HSIEH |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3291 SKYPARK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905055004 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 4824 |
| Number Of Medicare Beneficiaries | 491 |
| Total Submitted Charge Amount | 535884.73 |
| Total Medicare Allowed Amount | 430151.07 |
| Total Medicare Payment Amount | 330212.68 |
| Total Medicare Standardized Payment Amount | 309480.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1440 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 21600 |
| Total Drug Medicare AllowedAmount | 16480.24 |
| Total Drug Medicare PaymentAmount | 12743.82 |
| Total Drug Medicare Standardized Payment Amount | 12743.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 3384 |
| Number Of Medicare Beneficiaries With Medical Services | 491 |
| Total Medical Submitted Charge Amount | 514284.73 |
| Total Medical Medicare Allowed Amount | 413670.83 |
| Total Medical Medicare Payment Amount | 317468.86 |
| Total Medical Medicare Standardized Payment Amount | 296737.06 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 250 |
| Number Of Male Beneficiaries | 241 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 4.3267 |