National Provider Identifier [NPI]: |
1558416040 |
Last Name Of The Provider |
HAHN |
First Name Of The Provider |
SUHDONG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 SCHOOL ST |
Street Address 2 Of The Provider |
SUITE 107 |
City Of The Provider |
PAWTUCKET |
Zip Code Of The Provider |
028605334 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1039 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
127840.31 |
Total Medicare Allowed Amount |
82226.88 |
Total Medicare Payment Amount |
57481.33 |
Total Medicare Standardized Payment Amount |
56972.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
60.31 |
Total Drug Medicare AllowedAmount |
47.47 |
Total Drug Medicare PaymentAmount |
46.53 |
Total Drug Medicare Standardized Payment Amount |
46.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1005 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
127780 |
Total Medical Medicare Allowed Amount |
82179.41 |
Total Medical Medicare Payment Amount |
57434.8 |
Total Medical Medicare Standardized Payment Amount |
56925.77 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6343 |