National Provider Identifier [NPI]: |
1013211135 |
Last Name Of The Provider |
POON |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 E SPRING ST |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
908061625 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
144 |
Number Of Medicare Beneficiaries |
89 |
Total Submitted Charge Amount |
15877 |
Total Medicare Allowed Amount |
7683.61 |
Total Medicare Payment Amount |
5516.64 |
Total Medicare Standardized Payment Amount |
5087.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
60 |
Total Drug Medicare AllowedAmount |
18.6 |
Total Drug Medicare PaymentAmount |
16.95 |
Total Drug Medicare Standardized Payment Amount |
16.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
122 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
15817 |
Total Medical Medicare Allowed Amount |
7665.01 |
Total Medical Medicare Payment Amount |
5499.69 |
Total Medical Medicare Standardized Payment Amount |
5070.86 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
26 |
Number Of Non Hispanic White Beneficiaries |
71 |
Number Of Black or African American Beneficiaries |
|
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 |
78 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0345 |