National Provider Identifier [NPI]: |
1427010040 |
Last Name Of The Provider |
ZHANG |
First Name Of The Provider |
DAHUA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 CENTRAL AVE SE |
Street Address 2 Of The Provider |
PHS - LAB - S1 |
City Of The Provider |
ALBUQUERQUE |
Zip Code Of The Provider |
871064930 |
State Code Of The Provider |
NM |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1234 |
Number Of Medicare Beneficiaries |
443 |
Total Submitted Charge Amount |
204082 |
Total Medicare Allowed Amount |
41624.67 |
Total Medicare Payment Amount |
32343.9 |
Total Medicare Standardized Payment Amount |
26559.52 |
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 |
28 |
Number Of Medical Services |
1234 |
Number Of Medicare Beneficiaries With Medical Services |
443 |
Total Medical Submitted Charge Amount |
204082 |
Total Medical Medicare Allowed Amount |
41624.67 |
Total Medical Medicare Payment Amount |
32343.9 |
Total Medical Medicare Standardized Payment Amount |
26559.52 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
181 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
253 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
134 |
Number Of American Indian Alaska Native Beneficiaries |
33 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5795 |