National Provider Identifier [NPI]: |
1023270089 |
Last Name Of The Provider |
SHIN |
First Name Of The Provider |
JOYCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1225 WILSHIRE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900171901 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
512 |
Number Of Medicare Beneficiaries |
251 |
Total Submitted Charge Amount |
576100 |
Total Medicare Allowed Amount |
122922.88 |
Total Medicare Payment Amount |
96255.65 |
Total Medicare Standardized Payment Amount |
92777.43 |
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 |
61 |
Number Of Medical Services |
512 |
Number Of Medicare Beneficiaries With Medical Services |
251 |
Total Medical Submitted Charge Amount |
576100 |
Total Medical Medicare Allowed Amount |
122922.88 |
Total Medical Medicare Payment Amount |
96255.65 |
Total Medical Medicare Standardized Payment Amount |
92777.43 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
64 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
104 |
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.4341 |