National Provider Identifier [NPI]: |
1134162803 |
Last Name Of The Provider |
CHOI |
First Name Of The Provider |
ESTHER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2202 WILSHIRE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SANTA MONICA |
Zip Code Of The Provider |
904035706 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nuclear Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
450 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
2105189 |
Total Medicare Allowed Amount |
424110.21 |
Total Medicare Payment Amount |
330966.96 |
Total Medicare Standardized Payment Amount |
330966.96 |
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 |
6 |
Number Of Medical Services |
450 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
2105189 |
Total Medical Medicare Allowed Amount |
424110.21 |
Total Medical Medicare Payment Amount |
330966.96 |
Total Medical Medicare Standardized Payment Amount |
330966.96 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
171 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
44 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3737 |