National Provider Identifier [NPI]: |
1356450498 |
Last Name Of The Provider |
AHN |
First Name Of The Provider |
ELIZA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15243 VANOWEN ST |
Street Address 2 Of The Provider |
SUITE406 |
City Of The Provider |
VAN NUYS |
Zip Code Of The Provider |
914053605 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
6128 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
352625 |
Total Medicare Allowed Amount |
180558.95 |
Total Medicare Payment Amount |
145750.74 |
Total Medicare Standardized Payment Amount |
137641.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
336 |
Number Of Medicare Beneficiaries With Drug Services |
81 |
Total Drug Submitted ChargeAmount |
13775 |
Total Drug Medicare AllowedAmount |
2414.17 |
Total Drug Medicare PaymentAmount |
2057.16 |
Total Drug Medicare Standardized Payment Amount |
2057.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
5792 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
338850 |
Total Medical Medicare Allowed Amount |
178144.78 |
Total Medical Medicare Payment Amount |
143693.58 |
Total Medical Medicare Standardized Payment Amount |
135584.36 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
72 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
30 |
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
64 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
31 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.0116 |