National Provider Identifier [NPI]: |
1962561605 |
Last Name Of The Provider |
TANG |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4275 VIA ARBOLADA |
Street Address 2 Of The Provider |
#209 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900425101 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
595 |
Number Of Medicare Beneficiaries |
249 |
Total Submitted Charge Amount |
365824.8 |
Total Medicare Allowed Amount |
107840.25 |
Total Medicare Payment Amount |
83671.58 |
Total Medicare Standardized Payment Amount |
84415.18 |
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 |
81 |
Number Of Medical Services |
595 |
Number Of Medicare Beneficiaries With Medical Services |
249 |
Total Medical Submitted Charge Amount |
365824.8 |
Total Medical Medicare Allowed Amount |
107840.25 |
Total Medical Medicare Payment Amount |
83671.58 |
Total Medical Medicare Standardized Payment Amount |
84415.18 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
199 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9012 |