National Provider Identifier [NPI]: |
1295878254 |
Last Name Of The Provider |
TSOI |
First Name Of The Provider |
EDMUND |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
950 STOCKTON ST |
Street Address 2 Of The Provider |
388 |
City Of The Provider |
SAN FRANCISCO |
Zip Code Of The Provider |
941081633 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
633 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
219267.55 |
Total Medicare Allowed Amount |
109716.77 |
Total Medicare Payment Amount |
84982.62 |
Total Medicare Standardized Payment Amount |
74163.94 |
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 |
78 |
Number Of Medical Services |
633 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
219267.55 |
Total Medical Medicare Allowed Amount |
109716.77 |
Total Medical Medicare Payment Amount |
84982.62 |
Total Medical Medicare Standardized Payment Amount |
74163.94 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
18 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
195 |
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 |
28 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
34 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5957 |