National Provider Identifier [NPI]: |
1326110651 |
Last Name Of The Provider |
TRAN |
First Name Of The Provider |
KHAI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1304 FAWCETT AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984021911 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
4141 |
Number Of Medicare Beneficiaries |
1976 |
Total Submitted Charge Amount |
1017125.5 |
Total Medicare Allowed Amount |
318277.64 |
Total Medicare Payment Amount |
277392.48 |
Total Medicare Standardized Payment Amount |
277188.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
316 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
2652 |
Total Drug Medicare AllowedAmount |
656.93 |
Total Drug Medicare PaymentAmount |
515.06 |
Total Drug Medicare Standardized Payment Amount |
515.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
3825 |
Number Of Medicare Beneficiaries With Medical Services |
1976 |
Total Medical Submitted Charge Amount |
1014473.5 |
Total Medical Medicare Allowed Amount |
317620.71 |
Total Medical Medicare Payment Amount |
276877.42 |
Total Medical Medicare Standardized Payment Amount |
276673.82 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
1094 |
Number Of Beneficiaries Age 75 to 84 |
556 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
1941 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
1635 |
Number Of Black or African American Beneficiaries |
117 |
Number Of AsianPacific Islander Beneficiaries |
104 |
Number Of Hispanic Beneficiaries |
56 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
49 |
Number Of Beneficiaries With Medicare Only Entitlement |
1712 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
264 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8975 |