| National Provider Identifier [NPI]: |
1225172620 |
| Last Name Of The Provider |
FU |
| First Name Of The Provider |
XING |
| Middle Initial Of The Provider |
|
| Credentials Of The Provider |
MD |
| Gender Of The Provider |
F |
| Entity Type Of The Provider |
I |
| Street Address 1 Of The Provider |
1909 214TH ST SE STE 300 |
| Street Address 2 Of The Provider |
|
| City Of The Provider |
BOTHELL |
| Zip Code Of The Provider |
980214418 |
| State Code Of The Provider |
WA |
| Country Code Of The Provider |
US |
| Provider Type Of The Provider |
Pain Management |
| Medicare Participation Indicator |
Y |
| Number Of HCPCS |
46 |
| Number Of Services |
599 |
| Number Of Medicare Beneficiaries |
158 |
| Total Submitted Charge Amount |
185117 |
| Total Medicare Allowed Amount |
66263.04 |
| Total Medicare Payment Amount |
50011.81 |
| Total Medicare Standardized Payment Amount |
46599.39 |
| Drug Suppress Indicator |
|
| Number Of HCPCS Associated With Drug Services |
1 |
| Number Of Drug Services |
76 |
| Number Of Medicare Beneficiaries With Drug Services |
11 |
| Total Drug Submitted ChargeAmount |
304 |
| Total Drug Medicare AllowedAmount |
135.4 |
| Total Drug Medicare PaymentAmount |
106.17 |
| Total Drug Medicare Standardized Payment Amount |
106.17 |
| Medical SuppressIndicator |
|
| Number Of HCPCS Associated With MedicalServices |
45 |
| Number Of Medical Services |
523 |
| Number Of Medicare Beneficiaries With Medical Services |
158 |
| Total Medical Submitted Charge Amount |
184813 |
| Total Medical Medicare Allowed Amount |
66127.64 |
| Total Medical Medicare Payment Amount |
49905.64 |
| Total Medical Medicare Standardized Payment Amount |
46493.22 |
| Average Age Of Beneficiaries |
70 |
| Number Of Beneficiaries Age Less65 |
41 |
| Number Of Beneficiaries Age 65 to 74 |
66 |
| Number Of Beneficiaries Age 75 to 84 |
35 |
| Number Of Beneficiaries Age Greater 84 |
16 |
| Number Of Female Beneficiaries |
93 |
| Number Of Male Beneficiaries |
65 |
| Number Of Non Hispanic White Beneficiaries |
115 |
| Number Of Black or African American Beneficiaries |
14 |
| Number Of AsianPacific Islander Beneficiaries |
16 |
| Number Of Hispanic Beneficiaries |
|
| Number Of American Indian Alaska Native Beneficiaries |
0 |
| Number Of Beneficiaries With Race Not Else where Classified |
|
| Number Of Beneficiaries With Medicare Only Entitlement |
103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
| Percent Of With Atrial Fibrillation |
7 |
| Percent Of With Alzheimers Disease or Dementia |
9 |
| Percent Of With Asthma |
8 |
| Percent Of With Cancer |
8 |
| Percent Of With Heart Failure |
13 |
| Percent Of With Chronic Kidney Disease |
25 |
| Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
| Percent Of With Depression |
37 |
| Percent Of With Diabetes |
32 |
| Percent Of With Hyperlipidemia |
49 |
| Percent Of With Hypertension |
58 |
| Percent Of With Ischemic Heart Disease |
22 |
| Percent Of With Osteoporosis |
9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
| Percent Of With Schizophrenia Other PsychoticDisorders |
|
| Percent Of With Stroke |
|
| Average HCC Risk Score Of Beneficiaries |
1.5351 |