National Provider Identifier [NPI]: |
1356549331 |
Last Name Of The Provider |
WANG |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12462 PUTNAM ST |
Street Address 2 Of The Provider |
STE 206 |
City Of The Provider |
WHITTIER |
Zip Code Of The Provider |
906021048 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
18664 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
330649 |
Total Medicare Allowed Amount |
162960.93 |
Total Medicare Payment Amount |
125596.45 |
Total Medicare Standardized Payment Amount |
118921.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
17163 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
96389 |
Total Drug Medicare AllowedAmount |
38064.11 |
Total Drug Medicare PaymentAmount |
29060.53 |
Total Drug Medicare Standardized Payment Amount |
29060.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1501 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
234260 |
Total Medical Medicare Allowed Amount |
124896.82 |
Total Medical Medicare Payment Amount |
96535.92 |
Total Medical Medicare Standardized Payment Amount |
89861.4 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
79 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
68 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
42 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2099 |