National Provider Identifier [NPI]: |
1689602112 |
Last Name Of The Provider |
CHEN |
First Name Of The Provider |
DEFENG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
613 ELIZABETH ST |
Street Address 2 Of The Provider |
STE. 702 |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784042220 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
3788 |
Number Of Medicare Beneficiaries |
540 |
Total Submitted Charge Amount |
777229 |
Total Medicare Allowed Amount |
372761.25 |
Total Medicare Payment Amount |
291578.01 |
Total Medicare Standardized Payment Amount |
300967.33 |
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 |
23 |
Number Of Medical Services |
3788 |
Number Of Medicare Beneficiaries With Medical Services |
540 |
Total Medical Submitted Charge Amount |
777229 |
Total Medical Medicare Allowed Amount |
372761.25 |
Total Medical Medicare Payment Amount |
291578.01 |
Total Medical Medicare Standardized Payment Amount |
300967.33 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
246 |
Number Of Non Hispanic White Beneficiaries |
220 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
284 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
260 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
280 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
44 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
66 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
3.6255 |