National Provider Identifier [NPI]: |
1033405493 |
Last Name Of The Provider |
CHOI |
First Name Of The Provider |
DAMON |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
277 PLEASANT ST |
Street Address 2 Of The Provider |
4TH FLOOR |
City Of The Provider |
FALL RIVER |
Zip Code Of The Provider |
027213005 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
116 |
Number Of Medicare Beneficiaries |
82 |
Total Submitted Charge Amount |
47434 |
Total Medicare Allowed Amount |
16018.53 |
Total Medicare Payment Amount |
12558.31 |
Total Medicare Standardized Payment Amount |
12373.36 |
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 |
9 |
Number Of Medical Services |
116 |
Number Of Medicare Beneficiaries With Medical Services |
82 |
Total Medical Submitted Charge Amount |
47434 |
Total Medical Medicare Allowed Amount |
16018.53 |
Total Medical Medicare Payment Amount |
12558.31 |
Total Medical Medicare Standardized Payment Amount |
12373.36 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
49 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
60 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
26 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.9515 |