National Provider Identifier [NPI]: |
1679797203 |
Last Name Of The Provider |
DANG |
First Name Of The Provider |
DAVID |
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 |
999 SAN BERNARDINO RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
UPLAND |
Zip Code Of The Provider |
917864920 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
171 |
Number Of Services |
5238 |
Number Of Medicare Beneficiaries |
2913 |
Total Submitted Charge Amount |
473223 |
Total Medicare Allowed Amount |
164951.58 |
Total Medicare Payment Amount |
122266.55 |
Total Medicare Standardized Payment Amount |
120893.24 |
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 |
171 |
Number Of Medical Services |
5238 |
Number Of Medicare Beneficiaries With Medical Services |
2913 |
Total Medical Submitted Charge Amount |
473223 |
Total Medical Medicare Allowed Amount |
164951.58 |
Total Medical Medicare Payment Amount |
122266.55 |
Total Medical Medicare Standardized Payment Amount |
120893.24 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
452 |
Number Of Beneficiaries Age 65 to 74 |
1117 |
Number Of Beneficiaries Age 75 to 84 |
871 |
Number Of Beneficiaries Age Greater 84 |
473 |
Number Of Female Beneficiaries |
1925 |
Number Of Male Beneficiaries |
988 |
Number Of Non Hispanic White Beneficiaries |
1735 |
Number Of Black or African American Beneficiaries |
234 |
Number Of AsianPacific Islander Beneficiaries |
195 |
Number Of Hispanic Beneficiaries |
689 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1812 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1101 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.968 |