National Provider Identifier [NPI]: |
1659462695 |
Last Name Of The Provider |
CHAO |
First Name Of The Provider |
BO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
75 N COUNTRY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORT JEFFERSON |
Zip Code Of The Provider |
117772119 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1729 |
Number Of Medicare Beneficiaries |
563 |
Total Submitted Charge Amount |
380798 |
Total Medicare Allowed Amount |
191531.68 |
Total Medicare Payment Amount |
148308.55 |
Total Medicare Standardized Payment Amount |
131774.93 |
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 |
17 |
Number Of Medical Services |
1729 |
Number Of Medicare Beneficiaries With Medical Services |
563 |
Total Medical Submitted Charge Amount |
380798 |
Total Medical Medicare Allowed Amount |
191531.68 |
Total Medical Medicare Payment Amount |
148308.55 |
Total Medical Medicare Standardized Payment Amount |
131774.93 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
178 |
Number Of Female Beneficiaries |
312 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
517 |
Number Of Black or African American Beneficiaries |
19 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
389 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4554 |